Vol. 3 No. 27 Jul 2, 2021 COVID-19 ISSUE (15) Preplanned Studies Perception of the COVID-19 Epidemic and Acceptance of Vaccination Among Healthcare Workers Prior to Vaccine Licensure — Beijing Municipality, China, May–July 2020 569 Integrated Approaches for COVID-19 Case Finding and Their Impact on Timeliness for Disease Containment — Changning District, Shanghai Municipality, China, January–July, 2020 576 Perspectives Progress of Active Surveillance for Vaccine Safety in China 581 Notes from the Field Transmission Dynamics of an Outbreak of the COVID-19 Delta Variant B.1.617.2 — Guangdong Province, China, May–June 2021 584 Genome Characterization of the First Outbreak of COVID-19 Delta Variant B.1.617.2 — Guangzhou City, Guangdong Province, China, May 2021 587 China CDC Weekly Editorial Board Editor-in-Chief George F. Gao Deputy Editor-in-Chief Liming Li Gabriel M Leung Zijian Feng Executive Editor Feng Tan Members of the Editorial Board Xiangsheng Chen Xiaoyou Chen Zhuo Chen (USA) Xianbin Cong Gangqiang Ding Xiaoping Dong Mengjie Han Guangxue He Xi Jin Biao Kan Haidong Kan Qun Li Tao Li Zhongjie Li Min Liu Qiyong Liu Jinxing Lu Huiming Luo Huilai Ma Jiaqi Ma Jun Ma Ron Moolenaar (USA) Daxin Ni Lance Rodewald (USA) RJ Simonds (USA) Ruitai Shao Yiming Shao Xiaoming Shi Yuelong Shu Xu Su Chengye Sun Dianjun Sun Hongqiang Sun Quanfu Sun Xin Sun Jinling Tang Kanglin Wan Huaqing Wang Linhong Wang Guizhen Wu Jing Wu Weiping Wu Xifeng Wu (USA) Yongning Wu Zunyou Wu Lin Xiao Fujie Xu (USA) Wenbo Xu Hong Yan Hongyan Yao Zundong Yin Hongjie Yu Shicheng Yu Xuejie Yu (USA) Jianzhong Zhang Liubo Zhang Rong Zhang Tiemei Zhang Wenhua Zhao Yanlin Zhao Xiaoying Zheng Zhijie Zheng (USA) Maigeng Zhou Xiaonong Zhou Advisory Board Director of the Advisory Board Jiang Lu Vice-Director of the Advisory Board Yu Wang Jianjun Liu Members of the Advisory Board Chen Fu Gauden Galea (Malta) Dongfeng Gu Qing Gu Yan Guo Ailan Li Jiafa Liu Peilong Liu Yuanli Liu Roberta Ness (USA) Guang Ning Minghui Ren Chen Wang Hua Wang Kean Wang Xiaoqi Wang Zijun Wang Fan Wu Xianping Wu Jingjing Xi Jianguo Xu Jun Yan Gonghuan Yang Tilahun Yilma (USA) Guang Zeng Xiaopeng Zeng Yonghui Zhang Editorial Office Directing Editor Feng Tan Managing Editors Lijie Zhang Yu Chen Peter Hao (USA) Senior Scientific Editors Ning Wang Ruotao Wang Shicheng Yu Qian Zhu Scientific Editors Weihong Chen Xudong Li Nankun Liu Xi Xu Qing Yue Xiaoguang Zhang Ying Zhang Cover Photo: Nucleic acid sampling in the rain in Guangzhou City, in the early morning of May 26, 2021 (photo adapted from Chinanews.com). China CDC Weekly Preplanned Studies Perception of the COVID-19 Epidemic and Acceptance of Vaccination Among Healthcare Workers Prior to Vaccine Licensure — Beijing Municipality, China, May–July 2020 Luodan Suo1; Rui Ma1; Zhongzhan Wang2; Tian Tang2; Haihong Wang3; Fang Liu4; Jinfeng Tang5; Xinghui Peng6; Xue Guo7; Li Lu1,#; Xinghuo Pang1,# disease severity, and perceived risk of getting infected. Summary Multivariate analyses found two factors strongly What is already known about this topic? associated with willingness, “wanting the vaccine to be The coronavirus disease 2019 (COVID-19) vaccine free of charge” (OR: 5.78, 95% CI: 5.05–6.60, development has been progressing, but acceptance of P<0.001) and “belief that the vaccine was fully the new vaccines by healthcare workers (HCWs) was evaluated prior to licensure” (OR: 4.45, 95% CI: not well known prior to approval of COVID-19 3.81–5.20, P<0.001). One factor, “presence of an vaccines in China. underlying disease” was found to be negatively What is added by this report? associated with willingness (OR: 0.74, 95% CI: This study found that before vaccine approval, Beijing 0.61–0.90, P<0.001). The results supported a free HCWs expressed moderate willingness to get vaccination policy and use of effective measures to vaccinated. Factors positively influencing willingness remove barriers and convey accurate information about included free vaccination and belief that the vaccine COVID-19 vaccines to enhance acceptance of the had been fully evaluated. A negatively influencing vaccines among HCWs in China. factor was presence of an underlying disease. Trust in The COVID-19 pandemic, caused by the COVID-19 virus also known as SARS-CoV-2, has vaccines, in general, was positively associated with resulted in global public health and economic crises willingness to get new vaccines. (1). The general consensus is that successful vaccines What are the implications for public health should be developed to reduce morbidity and mortality practice? caused by the disease (2). Many countries have been COVID-19 vaccines should be provided at no cost to promoting vaccine research and achieving landmark HCWs. Effective measures should be taken to enhance results over the past months (3). Several vaccines the acceptance of COVID-19 vaccination among completed Phase III clinical trials and have been put HCWs in China. into extensive use. Based on previous experience, it is highly likely that The coronavirus disease 2019 (COVID-19) vaccines HCWs will be recommended as a priority population are expected to be widely used, but awareness and for vaccination. Experience has shown that even if acceptance of the new COVID-19 vaccines by vaccines are successfully developed, the acceptance may healthcare workers (HCWs) was not well known prior not be ideal (4). In China, where non-pharmacological to approval by China’s vaccine regulatory authority. interventions (5) have been strictly implemented and The research conducted a cross-sectional survey the epidemic effectively controlled, awareness and in Beijing to assess HCWs’ perceptions of the acceptance by HCWs of the new vaccines are not well COVID-19 epidemic and attitudes towards known. This study conducted a cross-sectional survey vaccination before COVID-19 vaccines were approved. in Beijing to provide a reference for formulating Multivariate analyses were used to evaluate factors rational vaccination strategies. associated with willingness to get vaccinated. A total of The setting was 6 (Chaoyang, Fengtai, Changping, 8,040 HCWs were recruited; 67.1% reported they Daxing, Miyun, and Huairou) of the 16 districts in would get vaccinated, while the rest were unsure or Beijing. Overall, ten hospitals, including two Level III indicated they would not get vaccinated. Factors general hospitals, two Level II general hospitals, and six associated with willingness to get vaccinated included Level I hospitals or communities health centers were the epidemic situation and its prognosis, perception of selected in each district by a systematic sampling Chinese Center for Disease Control and Prevention CCDC Weekly / Vol. 3 / No. 27 569 China CDC Weekly method. These hospitals were responsible for diagnosis proportion believed in the safety and effectiveness of and treatment of COVID-19 cases, community the vaccine; 73.0% reported their life had been population screening, and nucleic acid sampling during seriously disturbed by the epidemic in the past months; the epidemic. All doctors, nurses, and technicians in 43.6% estimated life and work would continue to be high-risk departments/units were included. In non- disturbed in the next six months (Table 1). high-risk departments, at least five doctors and five Respondents believed more in professional staff nurses were included, unless there were fewer than five advice (94.1%) compared with statements from media doctors or nurses, in which case all were included. (80.4%); 80.0% of HCWs were convinced the vaccine The investigation began in early May 2020 and had been fully evaluated in clinical trials, and 77.4% ended in mid-July 2020 (prior to emergency use wanted the vaccine to be free of charge; 67.1% of the authorization of any COVID-19 vaccine in China). An respondents reported they would get vaccinated, while anonymous questionnaire was administered through a 7.9% said they would not, and 25.0% were unsure. WeChat App. Questions included demographic The percentage of respondents who would advise characteristics, perceptions of risk towards the family members to get vaccinated (68.2%) was similar COVID-19 epidemic and severity of the disease, to their own willingness to be vaccinated; however, attitudes towards COVID-19 vaccination, and past fewer (61.9%) were willing to vaccinate their children. vaccination history. Five-point Likert scales were used, Among willing respondents, vaccination campaigns and responses were classified into three categories — organized by their hospital (75.3%) were more positive, negative, and uncertain. The research acceptable than vaccination offered by community implemented quality control measures to ensure clinics (24.7%). Doctors, nurses, and technicians achieving target numbers of respondents. answered questions similarly (Table 2). Univariate analysis included frequency and ratio Results of univariate logistic regression of intention calculations and Pearson’s chi-squared test for to accept COVID-19 vaccination and related variables differences. Multivariate stepwise logistic regression are shown in Table 3. In multiple logistic regression was used to evaluate factors associated with intention models, positive factors significantly associated with to accept vaccination. All variables significant at the intention to get vaccinated included “received other P<0.1 level in univariate logistic regression were vaccines in the past three years,” “received seasonal included in multivariable stepwise logistic regression influenza vaccine,” agreed with “suffering