COVID-19 vaccination coverage and its cognitive determinants among older adults in Shanghai, China, during the COVID-19 epidemic

Abstract

ObjectivesThis study aimed to examine the coverage of coronavirus disease 2019 (COVID-19) vaccination and its cognitive determinants among older adults.MethodsA cross-sectional study was conducted using a questionnaire to conduct a survey among 725 Chinese older adults aged 60 years and above in June 2022, 2 months after the mass COVID-19 outbreak in Shanghai, China. The questionnaire covered demographic characteristics, COVID-19 vaccination status, internal risk perception, knowledge, and attitude toward the efficacy and safety of COVID-19 vaccines.ResultsThe vaccination rate was 78.3% among the surveyed individuals. Self-reported reasons for unwillingness to get vaccinated (multiple selections) were “concerns about acute exacerbation of chronic diseases after vaccination (57.3%)” and “concerns regarding vaccine side effects (41.4%).” Compared to the unvaccinated group, the vaccinated group tended to have a higher score in internal risk perception (t = 2.64, P < 0.05), better knowledge of COVID-19 vaccines (t = 5.84, P < 0.05), and a more positive attitude toward the efficacy and safety of COVID-19 vaccines (t = 7.92, P < 0.05). The path analysis showed that the cognitive effect on vaccination behavior is relatively large, followed by the internal risk perception, and then the attitude toward COVID-19 vaccines. The more knowledgeable the participants were about COVID-19 vaccines, the more likely they were to receive the COVID-19 vaccines. In the multivariate logistic regression, the increased coverage of COVID-19 vaccination was associated with reduced age (OR = 0.53 95% CI 0.43–0.66, P < 0.001), being a resident in other places than Shanghai (OR = 0.40, 95% CI 0.17–0.92, P < 0.05), a shorter time of lockdown (OR = 0.33, 95% CI 0.13–0.83, P < 0.05), a history of other vaccines (OR = 2.58, 95% CI 1.45–4.60, P < 0.01), a fewer number of chronic diseases (OR = 0.49, 95% CI 0.38–0.62, P < 0.001), better knowledge about COVID-19 vaccines (OR = 1.60, 95% CI 1.17–2.19, P < 0.01), and a positive attitude toward COVID-19 vaccines (OR = 9.22, 95% CI 4.69–18.09, P < 0.001).ConclusionAcquiring accurate knowledge and developing a positive attitude toward COVID-19 vaccines are important factors associated with COVID-19 vaccination. Disseminating informed information on COVID-19 vaccines and ensuring efficacious communication regarding their efficacy and safety would enhance awareness about COVID-19 vaccination among older adults and consequently boost their vaccination coverage.

The Fear of SARS-CoV-2 Infection versus the Perception of COVID-19 Vaccination amongst Older Adults in Urban Areas (CoV-VAC-PL Study): A Polish Community-Based Study

“…Related publications have proven that the COVID-19 vaccination acceptance rate among the individuals aged 75 years and older is significantly lower as compared to older adults aged 65–74 years [ 64 ]. Similar conclusions were arrived at by Wei et al [ 56 ], as they were indicative of an explicit declining trend for the vaccination coverage rate among older adults: namely, the older the adults, the lower the vaccination coverage rate. We have not confirmed that particular observation by means of our study.…”

“…The related literature also refers to countries in which the level of acceptance of vaccination in the case of the population of older adults is significantly lower. The study conducted by Wei et al [ 56 ] indicated that 78.3% of older adults have been vaccinated against COVID-19, and for slightly more than a half of them, a booster dose had been administered. A study conducted in Hong Kong (68.6%) indicated that 46.3% of respondents ≥55 of age were willing to be vaccinated against COVID-19 [ 57 , 58 ].…”

“…In the previous study, the corresponding percentage share was nearly equivalent and stood at 11.8% [ 27 ]. Almost every tenth older adult in the study conducted by Wei et al was not interested in any vaccination [ 56 ]. According to Al-Hanawi et al [ 61 ], over half of the older adults in Saudi Arabia (56.14%) refused to be vaccinated against COVID-19.…”

“…We have not confirmed that particular observation by means of our study. The related literature highlights older adults as being characterized by a higher acceptance rate for the vaccine against COVID-19 because older adults are more exposed to SARS-CoV-2 infection [ 56 ].…”