Willingness and Uptake of the COVID-19 Testing and Vaccination in Urban China: An Online Cross-Sectional Survey at Early 2021

Background: Regular testing and vaccination are effective measures to mitigate the ongoing COVID-19 pandemic. Few studies have focused on COVID-19 testing and vaccination uptake may change as the pandemic continues. This study aims to examine willingness and uptake of COVID-19 testing and vaccination during a low-risk period of the COVID-19 pandemic in urban China. Methods: A cross-sectional online survey was conducted among 2244 adults in urban China. Descriptive analyses were performed to compare the respondents’ willingness and uptake of COVID-19 testing and vaccination. Multivariate logistic regressions were fitted to investigate the factors associated with willingness and uptake of the two measures. Findings: In early 2021, 52.45% of the respondents had received or scheduled a COVID-19 test at least once, and a majority (95.63%) were willing to receive testing. 63.28% of the respondents had received/scheduled or were willing to receive a COVID-19 vaccine. Willingness and uptake of COVID-19 testing were not associated with socio-demographic characteristics, except for occupation. Being of older age, migrants having higher educational attainment and secure employment were associated with a higher uptake of COVID-19 vaccination among the surveyed respondents, while willingness to vaccinate was consistent across socio-demographic characteristics among those who had not been vaccinated. Interpretation: Chinese adults expressed almost universal willingness of COVID-19 testing and relatively low willingness of COVID-19 vaccination at the low-risk period of the COVID-19 pandemic, independent from their socio-demographic characteristics. Maintaining willingness of COVID-19 vaccination are key especially when the pandemic evolved into a low-risk period. Funding Information: ZH acknowledges financial support from the National Natural Science Foundation of China (No. 71874034) and the Three-Year Initiative Plan for Strengthening Public Health System Construction in Shanghai (2020-2022) (GWV-10.1-XK23). Declaration of Interests: None. Ethics Approval Statement: The study was approved by the Institutional Review Board of the School of Public Health, Fudan University (IRB#2020-12-0861). Respondents provided e-consent for their participation in the survey.