Vaccine. 2025 Nov 25;69:128013. doi: 10.1016/j.vaccine.2025.128013. Online ahead of print.
ABSTRACT
BACKGROUND: Increasing vaccination coverage among older adults is a key post-pandemic public health priority. While seasonal influenza (SIV) and pneumococcal vaccines (PV) are widely available and subsidized in China, uptake remains low. This study explored post-pandemic willingness and determinants of SIV and PV uptake among older adults in Shenzhen.
METHODS: A cross-sectional survey of 1917 adults aged ≥60 years was conducted from January to May 2024. Descriptive statistics, chi-square tests, and multivariable logistic regression identified factors associated with willingness to receive future SIV and PV, and perceived pandemic influence, including sociodemographic characteristics, healthcare access, vaccination history, health beliefs, and policy awareness.
RESULTS: Willingness to receive SIV and PV was high (77.4 % and 73.4 %), but actual uptake was much lower (55.1 % and 29.2 %). Over 70 % of respondents reported increased willingness due to the COVID-19 pandemic. For SIV, key predictors included previous uptake (adjusted odds ratio [aOR] = 3.92, 95 % confidence interval [CI]: 3.00-5.15), concern about influenza (aOR = 1.96, 95 % CI: 1.52-2.52), awareness of free vaccination policy (aOR = 1.90, 95 % CI: 1.47-2.47), awareness of life-course vaccination (aOR = 1.60, 95 % CI: 1.11-2.35), having a family doctor (aOR = 1.54, 95 % CI: 1.10-2.14), and frequent health check-ups (aOR = 1.33, 95 % CI: 1.03-1.71). For PV, predictors included concern about pneumonia (aOR = 3.83, 95 % CI: 3.00-4.90), prior uptake (aOR = 3.08, 95 % CI: 2.18-4.45), free policy awareness (aOR = 2.91, 95 % CI: 2.27-3.74), having a family doctor (aOR = 1.78, 95 % CI: 1.27-2.48), frequent check-ups (aOR = 1.62, 95 % CI: 1.26-2.07), awareness of life-course vaccination (aOR = 1.45, 95 % CI: 1.03-2.09), and higher household income (aOR = 1.43, 95 % CI: 1.06-1.95). Willingness-to-pay remained low; healthcare providers, community channels, and traditional media were the main information sources.
CONCLUSION: While the pandemic increased vaccine willingness and uptake among older adults, an intention-behavior gap persists. Strengthening community-based services, life-course immunization promotion, policy communication, and expanded vaccine subsidies are crucial to sustaining uptake progress among this age group.
PMID:41297069 | DOI:10.1016/j.vaccine.2025.128013
