摘要目的:了解上海市闵行区50岁以上人群对流感、肺炎、带状疱疹及其疫苗的认知程度，分析不同支付情景下的接种意愿及其相关因素。方法:于2020年12月，采用分层随机抽样的方法，将上海市闵行区13个街道/镇的1 672名50~69岁人群纳入研究。采用问卷调查的方法收集调查对象基本情况，流感、肺炎、带状疱疹及其疫苗的认知水平、接种意愿等信息，采用χ2检验比较不同特征对象在不同支付场景下接种意愿的差异，采用 Kappa一致性检验比较不同支付场景下接种意愿的一致性，采用有序多分类logistic回归模型分析疫苗接种意愿的影响因素。 结果:1 672名调查对象平均年龄为（60.48±5.96）岁，其中男性777名（46.47%），男女比例为0.87∶1。上海户籍占80.74%（1 350名）。在不同支付场景下（自费、医保、免费），调查对象愿意为自己、父母、伴侣或子女任一对象接种流感、肺炎、带状疱疹疫苗的比例分别为80.6%、81.5%、74.0%。流感和肺炎疫苗在不同支付场景下的接种意愿相对稳定（ Kappa值≥0.6），而带状疱疹疫苗则差异较大（ Kappa值≤0.35）。有序多分类logistic回归分析结果显示，流感和流感疫苗的认知水平较高［ OR（95% CI）值分别为：1.111（1.054~1.170）、1.182（1.126~1.240）］、年龄50~59岁［ OR（95% CI）：1.305（1.085~1.531）］、上海户籍［ OR（95% CI）：1.372（1.079~1.721）］者接种流感疫苗的意愿更高，男性接种流感疫苗意愿更低［ OR（95% CI）：0.733（0.551~0.910）］；肺炎和肺炎疫苗的认知水平较高［ OR（95% CI）值分别为：1.837（1.152~2.517）、2.217（1.541~2.893）］者接种肺炎疫苗的意愿更高；年龄50~59岁［ OR（95% CI）：1.327（1.059~1.537）］、上海户籍［ OR（95% CI）：2.497（1.417~4.400）］者接种带状疱疹疫苗的意愿更高，相较于大专/本科及以上学历，初中及以下学历［ OR（95% CI）：0.664（0.396~0.992）］和高中/技校/职高/中专学历［ OR（95% CI）：0.559（0.324~0.964）］者接种带状疱疹疫苗意愿更低。 结论:上海市闵行区50岁以上人群在不同支付场景下，选择为自己、父母或伴侣任一对象接种流感、肺炎、带状疱疹疫苗的意愿存在一定差异，其中带状疱疹疫苗的差异较大。

abstractsObjective:To determine the knowledge of influenza, pneumonia, herpes zoster and related vaccines, willingness to vaccinate under multiple payment scenarios, and corresponding risk factors among people over 50 years old in Minhang District of Shanghai.Methods:A total of 1 672 respondents aged 50-69 from 13 communities/towns in Minhang district of Shanghai were included in this study using a stratified random sampling strategy on December 2020. The knowledge of influenza, pneumonia, herpes zoster and vaccines was investigated using a questionnaire, and the differences in the willingness under multiple payment scenarios were determined using chi-square test. The consistency in the willingness under multiple payment scenarios was compared using Cohen′s Kappa and the risk factors of the willingness was determined using ordinal logistic regression.Results:The average age of 1 672 respondents was (60.48±5.96) years old, including 777 (46.47%) males and 895 (53.53%) females. A total of 1 350 subjects (80.74%) had local household registration in Shanghai. The proportion of the willingness to vaccinate for themselves, spouses, and parents under any payment scenario was determined to be 80.6% (influenza vaccine), 81.5% (pneumonia vaccine), and 74.0% (herpes zoster vaccine). The willingness to vaccinate against influenza and pneumonia under multiple payment scenarios remained stable ( Kappa value ≥0.6), while that against herpes zoster infection was inconsistent ( Kappa value ≤0.35). Logistic regression analysis showed that respondents who had higher knowledge of influenza and influenza vaccine [ OR (95% CI): 1.111 (1.054-1.170), 1.182 (1.126-1.240), respectively], aged 50-59 [1.305 (1.085-1.531)] and local household registration in Shanghai [1.372 (1.079-1.721)] had higher willingness to vaccinate against influenza, while males had lower willingness [0.733 (0.551-0.910)]. Respondents who had higher knowledge of pneumonia and pneumonia vaccine [ OR (95% CI): 1.837 (1.152-2.517), 2.217 (1.541-2.893), respectively] had higher willingness to receive pneumonia vaccine. Respondents aged 50-59 [1.327 (1.059-1.537)] and with local household registration in Shanghai [2.497 (1.417-4.400)] were more likely to be vaccinated against herpes zoster, while those with middle school degree or below [0.664 (0.396-0.992)] and high school degree [0.559 (0.324-0.964)] were less likely to be vaccinated. Conclusion:Among people aged over 50 years old in Minhang district of Shanghai, the willingness to vaccinate for themselves, spouses, and parents against influenza, pneumonia and herpes zoster infection is quite different under multiple payment scenarios, especially for herpes zoster vaccine.