{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T22:58:20Z","timestamp":1781305100616,"version":"3.54.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2018,6,28]],"date-time":"2018-06-28T00:00:00Z","timestamp":1530144000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Michigan Office of Global Public Health"},{"name":"Mcubed Program University of Michigan"},{"DOI":"10.13039\/100001797","name":"PhRMA Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100001797","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Three-Year Public Health Action Plan of Shanghai, China","award":["15GWZK0101"],"award-info":[{"award-number":["15GWZK0101"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"published-print":{"date-parts":[[2018,12]]},"DOI":"10.1186\/s12889-018-5734-9","type":"journal-article","created":{"date-parts":[[2018,6,28]],"date-time":"2018-06-28T08:06:56Z","timestamp":1530173216000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The role of severity perceptions and beliefs in natural infections in Shanghai parents\u2019 vaccine decision-making: a qualitative study"],"prefix":"10.1186","volume":"18","author":[{"given":"Xiaodong","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuoying","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4691-7802","authenticated-orcid":false,"given":"Abram L.","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa A.","family":"Prosser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erzhan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenlu","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J.","family":"Zikmund-Fisher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,6,28]]},"reference":[{"key":"5734_CR1","doi-asserted-by":"crossref","unstructured":"Eggleston K. Health Care for 1.3 Billion: An Overview of China\u2019s Health System [Internet]. 2012. Available from: \n                    http:\/\/fsi.stanford.edu\/sites\/default\/files\/AHPPwp_28.pdf\n                    \n                  .","DOI":"10.2139\/ssrn.2029952"},{"key":"5734_CR2","doi-asserted-by":"publisher","first-page":"2536","DOI":"10.1377\/hlthaff.2012.1017","volume":"31","author":"T Cheng","year":"2012","unstructured":"Cheng T. Early Results Of China\u2019s Historic Health Reforms: The View From Minister Chen Zhu. Heal. Aff. 2012;31:2536\u201344.","journal-title":"Heal. Aff."},{"key":"5734_CR3","first-page":"6649","volume":"32","author":"E Dub\u00e9","year":"2014","unstructured":"Dub\u00e9 E, Gagnon D, Nickels E, Jeram S, Schuster M. Mapping vaccine hesitancy-Country-specific characteristics of a global phenomenon. Vaccine. Elsevier Ltd. 2014;32:6649\u201354.","journal-title":"Vaccine. Elsevier Ltd"},{"key":"5734_CR4","unstructured":"China Food and Drug Administration. Supplementary application and approval procedure for imported drugs [Internet]. 2004. Available from: \n                    http:\/\/eng.sfda.gov.cn\/WS03\/CL0769\/61656.html\n                    \n                  ."},{"key":"5734_CR5","doi-asserted-by":"publisher","first-page":"e68169","DOI":"10.1371\/journal.pone.0068169","volume":"8","author":"Q He","year":"2013","unstructured":"He Q, Wang M, Xu J, Zhang C, Wang H, Zhu W, et al. Rotavirus vaccination coverage among children aged 2-59 months: a report from Guangzhou. China. PLoS One. 2013;8:e68169.","journal-title":"China. PLoS One."},{"key":"5734_CR6","doi-asserted-by":"publisher","first-page":"e97800","DOI":"10.1371\/journal.pone.0097800","volume":"9","author":"AL Wagner","year":"2014","unstructured":"Wagner AL, Sun X, Montgomery JP, Huang Z, Boulton ML. The Impact of Residency and Urbanicity on Haemophilus influenzae Type b and Pneumococcal Immunization in Shanghai Children: A Retrospective Cohort Study. PLoS One. 2014;9:e97800.","journal-title":"PLoS One."},{"key":"5734_CR7","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1016\/j.jclinepi.2005.09.002","volume":"58","author":"E Mills","year":"2005","unstructured":"Mills E, Jadad AR, Ross C, Wilson K. Systematic review of qualitative studies exploring parental beliefs and attitudes toward childhood vaccination identifies common barriers to vaccination. J Clin Epidemiol. 2005;58:1081\u20138.","journal-title":"J Clin Epidemiol."},{"key":"5734_CR8","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1016\/j.humimm.2012.03.014","volume":"73","author":"GA Poland","year":"2012","unstructured":"Poland GA, Jacobson RM. The clinician\u2019s guide to the anti-vaccinationists\u2019 galaxy. Hum. Immunol. 2012;73:859\u201366.","journal-title":"Hum. Immunol."},{"key":"5734_CR9","doi-asserted-by":"publisher","first-page":"4321","DOI":"10.1016\/j.vaccine.2006.03.003","volume":"24","author":"S Hilton","year":"2006","unstructured":"Hilton S, Petticrew M, Hunt K. \u201cCombined vaccines are like a sudden onslaught to the body\u201ds immune system\u2019: parental concerns about vaccine \u201coverload\u201d and \u201cimmune-vulnerability\u201d. Vaccine. 2006;24:4321\u20137.","journal-title":"Vaccine."},{"key":"5734_CR10","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1093\/fampra\/18.2.181","volume":"18","author":"RK Sporton","year":"2001","unstructured":"Sporton RK, Francis SA. Choosing not to immunize: are parents making informed decisions? Fam. Pract. 2001;18:181\u20138.","journal-title":"Fam. Pract."},{"key":"5734_CR11","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1186\/1471-2458-14-133","volume":"14","author":"LD Wang","year":"2014","unstructured":"Wang LD, Lam WW, Wu JT, Liao Q, Fielding R. Chinese immigrant parents\u2019 vaccination decision making for children: a qualitative analysis. BMC Public Health. 2014;14:133.","journal-title":"BMC Public Health."},{"key":"5734_CR12","first-page":"97","volume":"35","author":"Y Gong","year":"2004","unstructured":"Gong Y, Stanton BF, Von Seidlen L, Feng X, Nyamette A. Perceptions of Shigella and of Shigella vaccine among rural Chinese: compatibility with Western models of behavioral change. Southeast Asian J. Trop. Med. Public Health. 2004;35:97\u2013108.","journal-title":"Southeast Asian J. Trop. Med. Public Health."},{"key":"5734_CR13","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1186\/1471-2458-11-943","volume":"11","author":"L Bond","year":"2011","unstructured":"Bond L, Nolan T. Making sense of perceptions of risk of diseases and vaccinations: a qualitative study combining models of health beliefs, decision-making and risk perception. BMC Public Health BioMed Central Ltd. 2011;11:943.","journal-title":"BMC Public Health BioMed Central Ltd"},{"key":"5734_CR14","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1177\/00333549111260S215","volume":"126","author":"PJ Smith","year":"2011","unstructured":"Smith PJ, Humiston SG, Marcuse EK, Zhao Z, Dorell CG, Howes C, et al. Parental delay or refusal of vaccine doses, childhood vaccination coverage at 24 months of age, and the Health Belief Model. Public Heal Rep. 2011;126:135\u201346.","journal-title":"Public Heal Rep."},{"key":"5734_CR15","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/1471-2458-8-45","volume":"8","author":"DRM Timmermans","year":"2008","unstructured":"Timmermans DRM, Henneman L, Hirasing RA, van der Wal G. Parents\u2019 perceived vulnerability and perceived control in preventing Meningococcal C infection: a large-scale interview study about vaccination. BMC Public Health BioMed Central. 2008;8:45.","journal-title":"BMC Public Health BioMed Central"},{"key":"5734_CR16","first-page":"408","volume":"12","author":"WLM Ruijs","year":"2012","unstructured":"Ruijs WLM, Hautvast JLA, van Ansem WJC, van Ijzendoorn G, van der Velden K, Hulscher ME. How orthodox protestant parents decide on the vaccination of their children: a qualitative study. BMC Public Health. ???; 2012;12:408.","journal-title":"???"},{"key":"5734_CR17","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1186\/1471-2458-13-1183","volume":"13","author":"IA Harmsen","year":"2013","unstructured":"Harmsen IA, Mollema L, Ruiter RA, Paulussen TG, de Melker HE, Kok G. Why parents refuse childhood vaccination: a qualitative study using online focus groups. BMC Public Health. 2013;13:1183.","journal-title":"BMC Public Health."},{"key":"5734_CR18","doi-asserted-by":"publisher","first-page":"4362","DOI":"10.1016\/j.vaccine.2017.06.077","volume":"35","author":"AL Wagner","year":"2017","unstructured":"Wagner AL, Boulton ML, Sun X, Zhuoying H, Harmsen IA, Ren J, et al. Parents\u2019 concerns about vaccine scheduling in Shanghai. China. Vaccine. 2017;35:4362\u20137.","journal-title":"China. Vaccine."},{"key":"5734_CR19","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1186\/s12887-017-0900-2","volume":"17","author":"AL Wagner","year":"2017","unstructured":"Wagner AL, Boulton ML, Sun X, Mukherjee B, Huang Z, Harmsen IA, et al. Perceptions of measles, pneumonia, and meningitis vaccines among caregivers in Shanghai, China, and the Health Belief Model: a cross-sectional study. BMC Pediatr. 2017;17:143.","journal-title":"BMC Pediatr."},{"key":"5734_CR20","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"V Braun","year":"2006","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77\u2013101.","journal-title":"Qual Res Psychol."},{"key":"5734_CR21","unstructured":"American Academy of Arts and Sciences. Public Trust in Vaccines: Defining a Research Agenda. Cambridge, MA: American Academy of Arts and Sciences; 2014."},{"key":"5734_CR22","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/1471-2334-10-99","volume":"10","author":"H Seale","year":"2010","unstructured":"Seale H, Heywood AE, McLaws M-L, Ward KF, Lowbridge CP, Van D, et al. Why do I need it? I am not at risk! Public perceptions towards the pandemic (H1N1) 2009 vaccine. BMC Infect. Dis. 2010;10:99.","journal-title":"BMC Infect. Dis."},{"key":"5734_CR23","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1037\/0278-6133.26.2.136","volume":"26","author":"NT Brewer","year":"2007","unstructured":"Brewer NT, Chapman GB, Gibbons FX, Gerrard M, McCaul KD, Weinstein ND. Meta-analysis of the relationship between risk perception and health behavior: the example of vaccination. Heal. Psychol. 2007;26:136\u201345.","journal-title":"Heal. Psychol."},{"key":"5734_CR24","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1016\/S0277-9536(98)00140-3","volume":"47","author":"C-Y Lew-Ting","year":"1998","unstructured":"Lew-Ting C-Y, Hurwicz M-L, Berkanovic E. Personal constitution and the health status among Chinese elderly in Taipei and Los Angeles. Soc Sci Med. 1998;47:821\u201330.","journal-title":"Soc Sci Med."},{"key":"5734_CR25","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.socscimed.2016.04.011","volume":"158","author":"CT Low","year":"2016","unstructured":"Low CT, Lai PC, Li HD, Ho WK, Wong P, Chen S, et al. Neighbourhood effects on body constitution - A case study of Hong Kong. Soc. Sci. Med Elsevier Ltd. 2016;158:61\u201374.","journal-title":"Soc. Sci. Med Elsevier Ltd"},{"key":"5734_CR26","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1016\/j.ctim.2014.05.009","volume":"22","author":"W Wong","year":"2014","unstructured":"Wong W, Lo C, Lam K, Su Y, Lin SJ, Ziea ET, et al. Measuring body constitution: Validation of the Body Constitution Questionnaire (BCQ) in Hong Kong. Complement. Ther. Med. 2014;22:670\u201382.","journal-title":"Complement. Ther. Med."},{"key":"5734_CR27","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1136\/bmj.318.7184.624b","volume":"318","author":"R Tomlinson","year":"1999","unstructured":"Tomlinson R. China Cracks down on Counterfeit Medicines. BMJ. 1999;318:624.","journal-title":"BMJ."},{"key":"5734_CR28","first-page":"378","volume":"365","author":"X Sun","year":"2011","unstructured":"Sun X, Xu X, Zhang X. Neonatal Cyanosis from a Hemoglobin Variant Counterfeit Bevacizumab and Endophthalmitis Drug-Induced Effects on Erlotinib Metabolism. N Engl J Med. 2011;365:378\u20139.","journal-title":"N Engl J Med."},{"key":"5734_CR29","unstructured":"Hensley S, Fulton A. China Draws More Scrutiny For Food Safety Lapses [Internet]. NPR; 2011. Available from: \n                    http:\/\/www.npr.org\/blogs\/health\/2011\/06\/08\/137058402\/china-draws-more-scrutiny-for-food-safety-lapses\n                    \n                  ."},{"key":"5734_CR30","first-page":"25","volume":"5","author":"G Bloom","year":"2001","unstructured":"Bloom G, Han L. How Health Workers Earn a Living in China. Hum. Resour. Heal. Dev. J. 2001;5:25\u201338.","journal-title":"Hum. Resour. Heal. Dev. J."},{"key":"5734_CR31","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1093\/jac\/dkn153","volume":"62","author":"L Dong","year":"2008","unstructured":"Dong L, Yan H, Wang D. Antibiotic prescribing patterns in village health clinics across 10 provinces of Western China. J. Antimicrob. Chemother. 2008;62:410\u20135.","journal-title":"J. Antimicrob. Chemother."},{"key":"5734_CR32","doi-asserted-by":"publisher","first-page":"1705","DOI":"10.1016\/S0277-9536(99)00239-7","volume":"49","author":"P Streefland","year":"1999","unstructured":"Streefland P, Chowdhury AM, Ramos-Jimenez P. Patterns of vaccination acceptance. Soc. Sci. Med. 1999;49:1705\u201316.","journal-title":"Soc. Sci. Med."}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-018-5734-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12889-018-5734-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-018-5734-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,6,27]],"date-time":"2019-06-27T19:08:12Z","timestamp":1561662492000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/s12889-018-5734-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,28]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["5734"],"URL":"https:\/\/doi.org\/10.1186\/s12889-018-5734-9","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,28]]},"assertion":[{"value":"6 November 2017","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 June 2018","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 June 2018","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"XS is the head of the immunizations division at the Shanghai CDC. ZH and JR are staff members at the Shanghai CDC. ALW is a post-doctoral fellow at the University of Michigan. EX, BW, and WY were students at the University of Michigan at the time of the study. LAP is a Professor and Director of the Child Health Evaluation and Research Center at the University of Michigan. BJZ is an Associate Professor of Health Behavior & Health Education at the University of Michigan.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 information"}},{"value":"This research was performed in accordance with the Declaration of Helsinki and ethical approval was obtained from the Institutional Review Board at the University of Michigan (#HUM00112889) and an ethical review committee at the Shanghai Centers for Disease Control and Prevention (#2016-9). All participants provided oral informed consent. After completing the interview, participants were given an incentive of 80 renminbi.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Publisher\u2019s Note"}}],"article-number":"813"}}