Influenza vaccination uptake and associated factors among elderly population in Hong Kong: the application of the Health Belief Model

Abstract

The impact of influenza on elderly can be severe and fatal. Influenza vaccination (IV) has been shown to be effective in reducing influenza-related complications, but the IV uptake among elderly in Hong Kong remains low. This study investigated the prevalence and factors associated with IV among Chinese elderly in Hong Kong using the Health Belief Model (HBM). A total of 1101 Chinese elderly aged over 65 was randomly selected and completed a phone interview. Background information, experience of and intention to receive IV and IV-related knowledge and perceptions based on the HBM were measured. Results showed that 48.5 and 49.5% of the participants have ever been vaccinated and intended to receive IV, respectively. Female gender, having chronic disease, and participating in community activities were significantly associated with previous IV. Knowledge of the fact that IV is required every year, lower perceived side effect, IV price lower than HK$150, and recommendations from health care providers was associated with both previous IV and intention to be vaccinated in the next year. Interventions promoting IV among elderly should disseminate knowledge regarding the necessity of IV and correct misconceptions about the side effects of IV.

Factors influencing seasonal influenza vaccination behaviour among elderly people: a systematic review

“…Among these three studies, one was high quality 47 and two were moderate quality. 56,57 However, another study 45 reported that vaccination coverage was higher among elderly males than elderly females. This study was of moderate quality.…”

“…Three studies 47,56,57 suggested that elderly females were more likely to have a vaccination history and to have been vaccinated in the last 6 months than elderly males. Among these three studies, one was high quality 47 and two were moderate quality.…”

“…Health status and self-perceived health status Influenza vaccination coverage was higher among elderly people with one or more chronic diseases than among healthier elderly people. 32,39,56,57 Lau et al 51 found that elderly people with fewer chronic diseases were more likely to have been vaccinated than those with three or more diseases. However, this study also found that those with better physical function were more likely to have been vaccinated.…”

“…Elderly adults who scored more highly on knowledge questions were more likely to have been vaccinated 40,51,57,58 while unvaccinated subjects knew little about influenza symptoms 38 and the side-effects of the vaccine. 39 Elderly people would have more positive beliefs towards vaccination and be more likely to accept vaccination if they received knowledge/ information from healthcare professionals.…”

“…Beliefs regarding vaccine efficacy were strongly associated with vaccination uptake 30,32,41,48,53,56 and ever having been vaccinated. 33,34,40,47,50,57 Other studies showed that doubts about vaccine efficacy were widely cited as a reason for refusal. 39, 61 Abramson and Cohen-Noar 36 found that participants who wrongly believed that the vaccine provided complete protection were more likely to accept vaccination, but those who wrongly believed that it would cause influenza tended to refuse vaccination.…”