影響臺灣民眾施打新冠肺炎疫苗意願的因素

目的本研究目的在於觀察臺灣民眾新冠疫苗接種意願以及影響疫苗接種的相關因素，並希望透過進一步分析，探討身心健康狀況與接種意願之間的關聯性。方法本研究使用中央研究院「臺灣社會變遷基本調查計畫」第八期第二次計畫問卷設計之健康與醫療照顧資料庫，為次級資料分析，研究對象共計1200人，以有沒有去施打新冠肺炎疫苗為依變項，並挑選問卷中基本資料包含性別、年齡、籍貫、教育程度、婚姻狀況、宗教信仰、居住地、BMI、健康保險、工作狀況、職業別、平均每月收入、同住人口、政黨傾向等共14個項目；對嚴重特殊傳染性肺炎和疫苗接種的認知，包含接收網路疫苗接種資訊、認為感染 COVID-19 是不小心、認為接種疫苗弊大於利、認為生病產生免疫力優於接種疫苗、自費施打新冠疫苗意願、免費施打新冠疫苗意願；自我評量，包含 SF-12、曾自費健康檢查、有沒有慢性病、有沒有重大傷病卡、自認社會階層、運動次數、家中是否有需要被照護者、曾接種流感疫苗；對醫療系統與政府的信賴程度，包含對臺灣醫療保健系統的滿意度、對臺灣醫生的信任度、新冠疫情下對醫療系統的信任度變化、新冠疫情下對政府的信任度變化作為自變項。利用SPSS軟體進行次數分配、百分比、卡方檢定、邏輯斯迴歸分析，以此了解疫苗接種狀況與其他變項間的關係。結果研究結果顯示，有73.8%的民眾施打過新冠肺炎疫苗，經邏輯斯迴歸分析得知影響施打新冠疫苗與19項因素呈顯著相關性，為年齡50-59歲(OR=1.836, P=0.033)、年齡60-69歲(OR=3.753, P<0.001)、年齡≧70歲(OR=12.269, P<0.001) v.s.年齡19-29歲；籍貫為臺灣客家人及原住民(OR=2.035, P=0.008) v.s.臺灣閩南人；教育程度為高中職(OR=1.620, P=0.036) 、專科與大學(OR=2.687, P<0.001) 、研究所以上(OR=5.013 P<0.001) v.s. 國中及以下；已婚(OR=1.568, P=0.025) v.s. 未婚；居住地為鄉村(OR=0.446, P<0.001) v.s. 都市；BMI正常(OR=2.095, P=0.017) v.s. 過瘦；有全民健保和私人醫療保險(OR=1.582, P=0.010) v.s. 只有全民健保；職業別為醫療保健及社會工作服務業(OR=4.680, P=0.002) v.s. 其他；同住人口有17歲以下小孩及65歲以上長輩(OR=0.570, P=0.001) v.s. 沒有；不同意接種疫苗弊大於利(OR=1.690, P=0.005) v.s. 同意；願意自費施打新冠疫苗(OR=1.546, P=0.017) v.s. 不願意；願意免費施打新冠疫苗(OR=11.297, P<0.001) v.s. 不願意；生理健康分數高等級(OR=1.391, P=0.041) v.s. 低等級；曾自費健康檢查(OR=1.509, P=0.015) v.s. 未曾自費健康檢查；沒有慢性病(OR=0.584, P=0.002) v.s. 有慢性病；自認社會階層為中階層(OR=2.326, P<0.001)、高階層(OR=2.621, P=0.019) v.s. 低階層；運動次數為一個月幾次(OR=2.279, P=0.001)、一星期幾次(OR=2.093, P=0.001)、每天(OR=1.858, P=0.016) v.s. 從不運動；曾接種流感疫苗(OR=5.978, P<0.001) v.s. 未曾接種流感疫苗；新冠疫情下對醫療系統的信任度變化為增加者(OR=1.721, P=0.011) v.s. 信任度減少。結論影響臺灣地區民眾施打新冠疫苗的因素，以年齡 60歲以上、籍貫為臺灣客家人及原住民者、高中職以上者、已婚者、居住地為都市者、BMI指數正常者、有全民健保和私人醫療保險者、從事醫療保健及社會工作服務業者、同住人口中沒有17歲以下小孩及65歲以上長輩者、不認為接種疫苗是弊大於利者、願意自費施打新冠疫苗者、願意施打免費新冠疫苗者、PCS 高等級者、曾自費健康檢查者、有慢性病者、自認社會階層為中階層及高階層者、規律運動者、曾接種流感疫苗者、新冠疫情下對醫療系統的信任度變化為增加者，接種意願較高。

Objectives：The purpose of this study is to observe the willingness of Taiwanese people to receive the COVID-19 vaccine and the factors influencing their vaccination decisions. Additionally, it aims to explore the relationship between physical and mental health status and vaccination willingness through further analysis.Methods：This study utilizes the database from the "Taiwan Social Change Survey, Phase 8, Wave 2," designed by Academia Sinica, focusing on health and medical care. It is a secondary data analysis involving 1,200 participants, with COVID-19 vaccination status as the dependent variable. The study examines 14 demographic variables: gender, age, ethnicity, education level, marital status, religious belief, place of residence, BMI, health insurance, employment status, occupation, average monthly income, household size, political inclination, and more. It also considers factors related to COVID-19 and vaccination perception, including exposure to online vaccination information, beliefs about accidental infection, perceived benefits of vaccination, preference for immunity through illness over vaccination, willingness to pay for COVID-19 vaccination, and willingness to receive free vaccination. Self-assessment factors include the SF-12 health survey, history of self-paid health checks, presence of chronic diseases, possession of a major illness card, perceived social class, frequency of exercise, presence of household members requiring care, and history of influenza vaccination. Additionally, trust in the healthcare system and government variables, including satisfaction with Taiwan's healthcare system, trust in Taiwanese doctors, changes in trust towards the healthcare system and government during the COVID-19 pandemic, as independent variables. SPSS software is used to perform frequency distribution, percentage, chi-square tests, and logistic regression analysis to understand the relationship between vaccination status and other variables.Results：The study results show that 73.8% of the participants received the COVID-19 vaccine. Logistic regression analysis revealed that vaccination uptake was significantly associated with 19 factors. These factors include age groups 50-59 years (OR=1.836, P=0.033), 60-69 years (OR=3.753, P<0.001) and ≥70 years (OR=12.269, P<0.001) compared to 19-29 years; Hakka and Indigenous ethnicity (OR=2.035, P=0.008) compared to Min Nan; education levels of high school (OR=1.620, P=0.036), college (OR=2.687, P<0.001), and graduate school (OR=5.013, P<0.001) compared to junior high school and below; being married (OR=1.568, P=0.025) compared to unmarried; rural residence (OR=0.446, P<0.001) compared to urban; normal BMI (OR=2.095, P=0.017) compared to underweight; having both National Health Insurance and private health insurance (OR=1.582, P=0.010) compared to only National Health Insurance; occupation in healthcare and social work services (OR=4.680, P=0.002) compared to other occupations; living with children under 17 and elders over 65 (OR=0.570, P=0.001) compared to living alone; disagreeing that the disadvantages of vaccination outweigh the benefits (OR=1.690, P=0.005) compared to agreeing; willingness to pay for the COVID-19 vaccine (OR=1.546, P=0.017) compared to unwillingness; willingness to receive the vaccine for free (OR=11.297, P<0.001) compared to unwillingness; higher PCS levels (OR=1.391, P=0.041) compared to lower levels; having undergone self-paid health checks (OR=1.509, P=0.015) compared to not having undergone; having no chronic diseases (OR=0.584, P=0.002) compared to having chronic diseases; perceiving oneself as middle class (OR=2.326, P<0.001) or upper class (OR=2.621, P=0.019) compared to lower class; exercising a few times a month (OR=2.279, P=0.001), a few times a week (OR=2.093, P=0.001), or daily (OR=1.858, P=0.016) compared to never exercising; having received an influenza vaccine (OR=5.978, P<0.001) compared to not having received; increased trust in the healthcare system during the COVID-19 pandemic (OR=1.721, P=0.011) compared to decreased trust.Conclusion：The factors influencing COVID-19 vaccination uptake among Taiwanese people include being over 60 years old, being of Hakka or Indigenous ethnicity, having an education level of high school or above, being married, residing in urban areas, having a normal BMI, having both National Health Insurance and private health insurance, working in healthcare and social work services, living with no children under 17 and elderly adults over 65, not believing that the disadvantages of vaccination outweigh the benefits, willingness to pay for the COVID-19 vaccine, willingness to receive free COVID-19 vaccine, having a high PCS level, having undergone self-paid health checks, having chronic diseases, perceiving oneself as middle or upper class, exercising regularly, having received an influenza vaccine, and increased trust in the healthcare system during the COVID-19 pandemic. These factors are associated with a higher willingness to receive the COVID-19 vaccine.