花蓮縣未接種新冠肺炎疫苗高齡者不願意接種之因素調查

Factors Associated with Reluctance to COVID-19 Vaccination among Unvaccinated Older Adults in Hualien County

嚴重特殊傳染性肺炎，或被廣泛稱為新型冠狀病毒肺炎(COVID-19)，是自2020年初在全球爆發的一場公共衛生危機。雖然接種疫苗被公認為最重要控制疫情擴散和降低死亡率之方法，部分人群對於接種新冠肺炎疫苗仍持疑慮的態度。因此，本研究旨在探討於花蓮縣高齡未接種新冠肺炎疫苗者，其不願意接種的原因及相關因子。本研究資料來自花蓮縣衛生局所於2022年2月進行的「護老計畫-提升長者施打新冠疫苗施打覆蓋率」調查。未接種新冠疫苗者的有效問卷為11,637人，平均年齡為76.6歲，男性佔44.8%。當中，表示沒有意願接種者佔92.6%，其主要原因為擔心接種後副作用(50.2%)。結果分別以「沒有接種疫苗的原因為擔心接種後副作用」和「沒有接種疫苗的原因為慢性病、健康不佳、年齡太大或醫生建議不打」作為多變項羅吉斯迴歸分析的依變項。結果顯示女性、相比70歲者，年齡為>80歲者以及不同的戶籍地區為顯著獨立因子。綜合而言，花蓮縣沒有意願接種新冠肺炎疫苗的高齡者的主要原因為擔心接種後的副作用。年齡、性別及戶籍地區可以影響高齡者接種疫苗的意願。未來可探討如何針對以上因子，提供高齡者有關疫苗安全性和副作用的正確且易於理解之資訊，建立對疫苗的信任和接受度，進而增加疫苗的覆蓋率。

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), also commonly referred to as Coronavirus Disease 2019 (COVID-19), has been a global public health crisis since its outbreak in early 2020. Although vaccination is recognized as a crucial measure for controlling the spread of the epidemic and reducing the mortality rate, some people still express reservations about receiving the COVID-19 vaccine. Therefore, this study aimed to investigate the reasons and associated factors for the reluctance to receive the COVID-19 vaccine among unvaccinated older adults in Hualien County. The data for this study were obtained from a survey conducted by the Hualien County Health Bureau in February 2022 as part of the“The Senior Care Project - Enhancing COVID-19 Vaccination Coverage Rate”. A total of 11,637 valid questionnaires from unvaccinated individuals were analyzed, with an average age of 76.6 years, and 44.8% of them were men. Among them, 92.6% expressed reluctance to be vaccinated, primarily concerned about postvaccination side effects (50.2%). The results were analyzed using multiple logistic regression, with the dependent variables being“reason for not vaccinating is concern about its side effects”and“reason for not vaccinating is chronic illness, poor health, old age, or doctor’s recommendation against it.”The results showed that being female, being over 80 years old, and different household registration areas were significant independent factors. In conclusion, the main reason for the reluctance to vaccinate against COVID-19 among older adults in Hualien County was concerns about side effects after vaccination. Age, sex, and household registration area could influence the willingness to get vaccinated. Future studies may explore how to provide accurate and easy-to-understand information about vaccine safety and side effects, to build trust and acceptance of the vaccine, and thereby increase vaccination coverage.