{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:59:05Z","timestamp":1790315945488,"version":"4.1.0"},"reference-count":29,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T00:00:00Z","timestamp":1662422400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research and Application of Medical and Social Support Index System","award":["20180418083FG"],"award-info":[{"award-number":["20180418083FG"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: As an important part of the promotion of immunization programs and the suppression of infectious diseases, paid vaccines can prevent a variety of diseases and meet the needs of different populations. However, few studies focus on the public\u2019s intention to pay for vaccination. Methods: The survey was conducted from 10 July to 15 September 2021, adopting a cross-sectional survey in China. We used a multi-stage sampling strategy to recruit participators from 120 cities. Participants filled out questions which assessed their intentions to pay for vaccination. A linear regression analysis was given to identify the predictors associated with the subjects\u2019 attitudes. Results: There were 11,031 residents who finished our questionnaire. Chinese residents\u2019 intention to receive paid vaccines scored 74.5 points. Residents who were male (\u03b2 = \u22120.03) and older (30\u201344 (\u03b2 = \u22120.03) or 45\u201359 (\u03b2 = \u22120.06) or \u226560 (\u03b2 = \u22120.08)), living alone (\u03b2 = \u22120.03), who had moderate to severe anxiety (\u03b2 = \u22120.03) or severe anxiety (\u03b2 = \u22120.03) were more likely to refuse vaccination, while those who lived in Western China (\u03b2 = 0.03) who had higher PSSS scores and HLS-SF12 index might acquire the intention to pay for vaccination. Conclusions: The study found that gender, age, region, living alone, anxiety, social support, and health literacy were the main influencing factors of residents\u2019 attitudes. Governments and health institutions should take targeted measures to improve the health literacy and mental health of the population in order to facilitate the implementation of vaccination withdrawal and immunization policies.<\/jats:p>","DOI":"10.3390\/ijerph191811154","type":"journal-article","created":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T05:17:23Z","timestamp":1662441443000},"page":"11154","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Intention to Pay for Vaccination and Influencing Factors of General Residents: A National Cross-Sectional Study"],"prefix":"10.3390","volume":"19","author":[{"given":"Weixin","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyu","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nana","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huifang","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujia","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Humanities and Social Sciences, Harbin Medical University, Harbin 150081, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health, Shaanxi University of Chinese Medicine, Xi\u2019an 712046, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Labor Economics and Management, Beijing Vocational College of Labour and Social Security, Beijing 100029, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9607-313X","authenticated-orcid":false,"given":"Yibo","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Public Health, Peking University, Beijing 100083, China"},{"name":"Health Culture Research Center of Shaanxi, Key Research Base of Philosophy and Social Sciences in Shaanxi Province, Xi\u2019an 710016, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Gan","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun 130012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1016\/j.jval.2018.03.014","article-title":"Model Comparisons of the Effectiveness and Cost-Effectiveness of Vaccination: A Systematic Review of the Literature","volume":"21","author":"Drolet","year":"2018","journal-title":"Value Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1377\/hlthaff.2011.1272","article-title":"To save children\u2019s lives, China should adopt an initiative to speed introduction of pneumonia vaccines","volume":"31","author":"Yu","year":"2012","journal-title":"Health Aff."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Zhuang, J., Wagner, A.L., Laffoon, M., Lu, Y., and Jiang, Q. (2019). Procurement of Category 2 Vaccines in China. Vaccines, 7.","DOI":"10.3390\/vaccines7030097"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"103854","DOI":"10.1016\/j.ijnurstu.2020.103854","article-title":"Editor\u2019s Choice: Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: A survey","volume":"114","author":"Kwok","year":"2021","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"6343","DOI":"10.1016\/j.vaccine.2016.10.051","article-title":"Cost-effectiveness analysis of pneumococcal vaccination for infants in China","volume":"34","author":"Maurer","year":"2016","journal-title":"Vaccine"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"6164","DOI":"10.1016\/j.vaccine.2015.09.081","article-title":"Systematic review of economic evaluations of vaccination programs in mainland China: Are they sufficient to inform decision making?","volume":"33","author":"Pan","year":"2015","journal-title":"Vaccine"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1016\/S0140-6736(17)32606-5","article-title":"HPV vaccination in China needs to be more cost-effective","volume":"390","author":"Yin","year":"2017","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"871","DOI":"10.4065\/84.10.871","article-title":"Incidence of invasive pneumococcal disease among children after introduction of a 7-valent pneumococcal conjugate vaccine: A population-based study in Olmsted County, Minnesota","volume":"84","author":"Tsigrelis","year":"2009","journal-title":"Mayo Clin. Proc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"6940","DOI":"10.1016\/j.vaccine.2012.05.084","article-title":"Projected health impact and cost-effectiveness of rotavirus vaccination among children <5 years of age in China","volume":"30","author":"Liu","year":"2012","journal-title":"Vaccine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"15016","DOI":"10.1038\/nrdp.2015.16","article-title":"Varicella zoster virus infection","volume":"1","author":"Gershon","year":"2015","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Wagner, A.L., Sun, X., Montgomery, J.P., Huang, Z., and Boulton, M.L. (2014). The impact of residency and urbanicity on Haemophilus influenzae Type b and pneumococcal immunization in Shanghai Children: A Retrospective Cohort Study. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0097800"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Liu, C., Nicholas, S., and Wang, J. (2020). The association between protection motivation and hepatitis b vaccination intention among migrant workers in Tianjin, China: A cross-sectional study. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-09292-2"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Lin, Y., Hu, Z., Zhao, Q., Alias, H., Danaee, M., and Wong, L.P. (2020). Understanding COVID-19 vaccine demand and hesitancy: A nationwide online survey in China. PLoS Negl. Trop. Dis., 14.","DOI":"10.1371\/journal.pntd.0008961"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1111\/jpc.13693","article-title":"Chinese medical students\u2019 knowledge, attitude and practice towards human papillomavirus vaccination and their intention to recommend the vaccine","volume":"54","author":"Liu","year":"2018","journal-title":"J. Paediatr. Child Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/00006842-198707000-00002","article-title":"Social support, type A behavior, and coronary artery disease","volume":"49","author":"Blumenthal","year":"1987","journal-title":"Psychosom. Med."},{"key":"ref_16","first-page":"e91","article-title":"Development and Validation of a New Short-Form Health Literacy Instrument (HLS-SF12) for the General Public in Six Asian Countries","volume":"3","author":"Duong","year":"2019","journal-title":"Health Lit. Res. Pract."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Duong, T.V., Nguyen, T.T.P., Pham, K.M., Nguyen, K.T., Giap, M.H., Tran, T.D.X., Nguyen, C.X., Yang, S.-H., and Su, C.-T. (2019). Validation of the Short-Form Health Literacy Questionnaire (HLS-SF12) and Its Determinants among People Living in Rural Areas in Vietnam. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16183346"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1080\/21645515.2020.1797368","article-title":"Human papillomavirus vaccination: Coverage rate, knowledge, acceptance, and associated factors in college students in mainland China","volume":"17","author":"Deng","year":"2021","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3602","DOI":"10.1016\/j.vaccine.2021.05.036","article-title":"Prevalence and determinants of SARS-CoV-2 vaccine hesitancy in Hong Kong: A population-based survey","volume":"39","author":"Luk","year":"2021","journal-title":"Vaccine"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Li, L., Wang, J., Nicholas, S., Maitland, E., Leng, A., and Liu, R. (2021). The Intention to Receive the COVID-19 Vaccine in China: Insights from Protection Motivation Theory. Vaccines, 9.","DOI":"10.3390\/vaccines9050445"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"106694","DOI":"10.1016\/j.ypmed.2021.106694","article-title":"Vaccination against COVID-19: A systematic review and meta-analysis of acceptability and its predictors","volume":"150","author":"Wang","year":"2021","journal-title":"Prev. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1080\/10810730.2018.1455771","article-title":"The Effect of Vaccine Literacy on Parental Trust and Intention to Vaccinate after a Major Vaccine Scandal","volume":"23","author":"Wang","year":"2018","journal-title":"J. Health Commun."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1037\/0033-2909.134.1.61","article-title":"Crisis decision theory: Decisions in the face of negative events","volume":"134","author":"Sweeney","year":"2008","journal-title":"Psychol. Bull."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1146\/annurev-psych-010416-044007","article-title":"Health Behavior Change: Moving from Observation to Intervention","volume":"68","author":"Sullivan","year":"2017","journal-title":"Annu. Rev. Psychol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wang, Y.J., Chen, X.P., Chen, W.J., Zhang, Z.L., Zhou, Y.P., and Jia, Z. (2020). Ethnicity and health inequalities: An empirical study based on the 2010 China survey of social change (CSSC) in Western China. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-08579-8"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1177\/1757975917731576","article-title":"Is college education an equalizer for social disparities in health literacy? A case study in Shanghai, China","volume":"26","author":"Hu","year":"2019","journal-title":"Glob. Health Promot."},{"key":"ref_29","first-page":"229","article-title":"Health economics in developing countries","volume":"92","year":"1989","journal-title":"J. Trop. Med. Hyg."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/18\/11154\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:24:00Z","timestamp":1760142240000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/18\/11154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,6]]},"references-count":29,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["ijerph191811154"],"URL":"https:\/\/doi.org\/10.3390\/ijerph191811154","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,6]]}}}