COVID-19 Vaccine Acceptance among Cold-Chain Food Workers in China: A Cross-Sectional Survey (Preprint)

BACKGROUND As cold-chain transportation in frozen food may lead to localized outbreaks of COVID-19 in destinations. Given the high level of exposure to SARS-CoV-2, the cold-chain food workers are considered priority vaccination groups. To date, a number of studies have reported the willingness to be vaccinated against COVID-19 within distinct populations, whereas it has not been reported among cold-chain food workers worldwide. OBJECTIVE We aim to investigate the willingness for COVID-19 vaccination and its influencing factors within cold-chain food workers during the COVID-19 pandemic. METHODS An online cross-sectional, population-based survey was employed to gather information regarding the willingness of COVID-19 vaccination and the knowledge, attitudes, and practices (KAP) associated with COVID-19 and vaccination among cold-chain food workers in Shenzhen City of China. Binomial logistic analyses were conducted to qualify the associations between COVID-19-related KAP factors and the willingness of COVID-19 vaccination using adjusted odds ratios (aORs) and 95% confidence interval (CI). RESULTS A total of 244 cold-chain food workers were recruited. Overall, 76.2% of the subjects indicated that they were willing to be vaccinated. After adjustment for general characteristics, knowledge on COVID-19 conception (aOR 2.313, 95%CI 1.098-4.872), comprehending the most effective measure (aOR 2.399, 95%CI 1.233-4.666), understanding the transmission routes (aOR 8.760, 95%CI 2.406-31.890), and recognizing the priority vaccination groups (aOR 2.587, 95%CI 1.331-5.029) were positively associated with the dependent variable. Regarding attitude factors, perceiving the social harmfulness (aOR 2.643, 95%CI 1.178-5.927) and severity of COVID-19 (aOR 3.109, 95%CI 1.116-8.660) were related to a higher willingness to get vaccinated. In terms of practice factors, participants who have attained more knowledge (aOR 2.608, 95%CI 1.115-6.099) were more likely to be vaccinated, and higher self-reported compliance with maintaining indoor ventilation (aOR 2.371, 95%CI 1.049-5.363) was also positively associated with the dependent variable. Agreement on the importance of vaccination to prevent COVID-19 was the most frequent reason for accepting the COVID-19 vaccine; additionally, concerns about side effects and poor understanding of efficacy were the main factors contributing to the vaccination refusal. CONCLUSIONS Enhancing KAP levels related to COVID-19 might be the key to promote vaccine acceptance. Health authorities ought to promptly implement educational activities following the updated vaccine situations.