Identifying influencing factors and intervention targets for intention strength in tetanus booster vaccination: A cross-sectional study among Chinese adults.

BACKGROUND

Tetanus is a vaccine-preventable disease, yet immunity declines with age, and adult booster uptake remains low. Limited evidence exists on adults' intention to receive tetanus booster vaccination.

AIMS: To assess the factors influencing adult intention to receive the tetanus booster, reveal the key mechanisms in the formation and strengthening of this intention.

METHODS

A cross-sectional online survey was conducted among 1522 adults in China. We collected data on general demographic characteristics and medical history; vaccination service preferences; knowledge related to tetanus; and behavioral responses. Multiple linear regression was used to identify factors associated with intention strength. Results are presented as unstandardized regression coefficients (B) with 95% confidence intervals (CI). Additionally, binary logistic regression was used to identify factors associated with low intention strength within the intention subgroup, with results presented as odds ratios (OR) and 95% CI. A two-sided P < 0.05 was considered statistically significant.

RESULTS

The mean intention strength for vaccination was low (4.73 ± 3.19). Determinants varied across various levels of intention. The time inconvenience (B = -0.52, 95% CI -0.96 to -0.07, P = 0.023) and uncertainty about the need for the vaccination (B = -0.73, 95% CI -1.23 to -0.22, P = 0.005) were negatively associated with the intention strength. In contrast, evening/weekend clinic availability (B = 0.80, 95% CI 0.34 to 1.26, P < 0.001) and community-based vaccination (B = 0.66, 95% CI 0.14 to 1.17, P = 0.013) were positively associated with intention strength. Subgroup analyses showed that compared to individuals who obtained information from official sources, those who obtained information through media (OR = 1.60, 95% CI 1.05 to 2.42, P = 0.028) had a higher risk of low behavioral intention.

CONCLUSION

Intention to receive tetanus booster vaccination among Chinese adults is generally low and varies across intention levels, highlighting the need for targeted interventions. Improving service accessibility and providing clear information may facilitate the translation from intention to action.