Survey on current status of knowledge acquisition and trust in information channels for non‑National Immunization Program vaccines and factor analysis in three provinces and one municipality of China

Objective To investigate Chinese adults’channels of acquiring knowledge about Non-National Immunization Program (non‑NIP) vaccines and their level of trust in these channels, thereby informing targeted health-education efforts.Methods A community-based survey was conducted in 30 counties (cities/districts) across Shandong, Anhui, Gansu provinces and Shanghai using a multi-stage stratified random sampling design. The study population comprised residents aged≥18 years. Data were collected via structured questionnaires covering participants’ demographic characteristics, information sources and trust levels regarding NIP vaccines. Univariate statistical analyses were applied to assess differences in channels of vaccine knowledge acquisition, and factor analysis was used to explore the latent trust structure underlying different information sources.Results A total of 4,105 adults participated. Findings indicated that adults primarily obtain vaccine-related information through professional medical channels, notably vaccination clinic staff, followed by official media reports. Trust scores were highest for vaccination clinic staff (mean 3.95) and hospital physicians (3.89), with official media information ranking third (3.34); other sources such as social networks and advertisements scored significantly lower (<3.30). Factor analysis extracted four principal factors: professional medical personnel recommendation, official channel reports, media channel reporting and interpersonal network recommendation, which together explained 88.12% of the variance. Demographic factors including sex, age, region, education level, income, and urban/rural residence were significantly associated with differing trust patterns across channels.Conclusion Although a diverse array of channels exists for NIP vaccine information dissemination, public trust is predominantly vested in professional medical personnel. However, the efficacy of medical-channel dissemination is limited by factors such as lack of performance incentives for healthcare workers, inadequate communication capacity, and uneven rural-urban information coverage. To enhance vaccine promotion, it is imperative to institute systemic incentives for medical personnel and to mobilize multi-channel collaboration.