COVID-19 Vaccine Hesitancy in China: Evolving Factors and Dynamic Changes

Strategic Insights -

COVID-19 vaccine hesitancy in China is a complex issue that has undergone significant changes over time. Recent research from Huaibei Normal University has shed light on the key factors influencing vaccine decision-making, revealing a shift from social norms to subjective experiences and from safety concerns to effectiveness priorities. The study employed a Gradient Boosting Decision Tree (GBDT) model and SHAP interpretability analysis on survey data from China, uncovering a range of factors, including social norms, vaccine knowledge, anticipated regret, age, vaccine safety, and education level. The findings suggest that COVID-19 vaccine hesitancy is dynamically evolving, with significant differences in the composition and significance of predictive factors between primary and booster vaccines. This research has crucial implications for formulating effective vaccination strategies, requiring a comprehensive consideration of multiple factors and timely adjustments to address changes in public concerns and decision-making mechanisms.

Key Takeaways:

  • The primary series of COVID-19 vaccines is influenced by social norms, vaccine knowledge, anticipated regret, age, vaccine safety, social responsibility, education level, religious belief, vaccine effectiveness, and perceived severity.
  • For booster shots, the important variables include age, vaccination experience, vaccine knowledge, vaccine effectiveness, gender, perceived severity, concerns about the epidemic, social norms, anticipated regret, and sense of social responsibility.
  • The study found a shift in the decision-making basis from social norms to subjective experiences, in the focus of vaccines from safety-first to effectiveness-priority, and in the decision-making mechanism from emotion-dominated to cognition-driven.
  • The research findings suggest that COVID-19 vaccine hesitancy is dynamically evolving, with changes in the composition and significance of predictive factors between primary and booster vaccines.
  • The study's conclusions emphasize the need for comprehensive consideration of multiple factors and timely adjustments to address changes in public concerns and decision-making mechanisms when developing vaccination strategies.
  • Hui Jing, Lei Li, Yuqi Zhao, Shenghua Wu, and Boyu Zhu conducted the research at Huaibei Normal University.
  • The study was published in the journal Human Vaccines & Immunotherapeutics in 2025, volume 21, issue 1, p. 2536898.

Statistics:

  • The study analyzed survey data from China to identify factors influencing COVID-19 vaccine hesitancy.
  • The GBDT model and SHAP interpretability analysis revealed a range of influencing factors, including social norms, vaccine knowledge, and anticipated regret.
  • The research found significant differences in the composition and significance of predictive factors between primary and booster vaccines.
  • For primary series of COVID-19 vaccines, the important factors include social norms, vaccine knowledge, anticipated regret, age, vaccine safety, social responsibility, education level, religious belief, vaccine effectiveness, and perceived severity.
  • For booster shots, the important variables include age, vaccination experience, vaccine knowledge, vaccine effectiveness, gender, perceived severity, concerns about the epidemic, social norms, anticipated regret, and sense of social responsibility.

Sources:

  • Huaibei Normal University
  • Human Vaccines & Immunotherapeutics, volume 21, issue 1, p. 2536898 (2025)
  • Taylor & Francis Inc, 530 Walnut Street, Ste 850, Philadelphia, PA 19106, USA
  • Hui Jing, School of Computer Science and Technology, Huaibei Normal University, Huaibei, People's Republic of China
  • Lei Li, Yuqi Zhao, Shenghua Wu, and Boyu Zhu (2025) Influencing factors and dynamic changes of COVID-19 vaccine hesitancy in China: From the perspective of machine learning analysis, Human Vaccines & Immunotherapeutics, 21(1), 2536898.