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This research investigates changes and factors influencing COVID-19 vaccine hesitancy among adults in China.

February 25, 2026

Dynamic trends and determinants of COVID-19 vaccine hesitancy among adults in China during 2021-2022: A multilevel analysis based on four national cross-sectional surveys.

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Cross-sectional surveys reveal fluctuating vaccine hesitancy trends in Chinese adults, suggesting targeted vaccination strategies are needed.

This research investigates changes and factors influencing COVID-19 vaccine hesitancy among adults in China.
Conducted four online cross-sectional surveys in January and June of 2021 and 2022.
Included participants aged 18 and older, weighted by the National Census.
Applied multilevel regression and post-stratification to assess provincial vaccine hesitancy rates.
Exploited multilevel logistic models to analyze sociodemographic factors and health belief model constructs.
Vaccine hesitancy showed a U-shaped trend, with rates of 33.78% in January 2021 and 31.72% in June 2022.
Initial hesitancy was largely due to safety concerns, shifting over time to reduced risk perception.
Demographic groups including younger adults, women, and urban residents exhibited higher hesitancy.
Health belief model factors played a critical role but diminished over time.

Xie et al. (2026) studied this question.

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Cross-sectional surveys reveal fluctuating vaccine hesitancy trends in Chinese adults, suggesting targeted vaccination strategies are needed.