Determinants of tetanus, pneumococcal and influenza vaccination in the elderly: a representative cross-sectional study on knowledge, attitude and practice (KAP)

Abstract

BackgroundSeverity and incidence of vaccine-preventable infections with influenza viruses, s. pneumoniae and c. tetani increase with age. Furthermore, vaccine coverage in the elderly is often insufficient. The aim of this study is to identify socio-economic and knowledge-, attitude- and practice- (KAP)-related determinants of vaccination against influenza, pneumococcal disease and tetanus in the older German population.MethodsWe analysed data from a German nationally representative questionnaire-based KAP-survey on infection prevention and hygiene behavior in the elderly (n = 1223). We used logistic regressions to assess impacts of socio-demographic- and KAP-related variables on vaccine uptake in general and on tetanus-, influenza- and pneumococcal vaccination. To generate KAP-scores, we applied factor analyses and analysed scores as predictors of specific vaccinations.ResultsA low rated personal health status was associated with a higher uptake of influenza vaccine whereas place of residence within Germany strongly impacted on pneumococcal vaccination. For tetanus and influenza vaccination, the strongest single vaccination predictor was attitude-related, i.e., the perceived importance of the vaccine (OR = 18.1, 95 % CI = 4.5–71.8; OR = 23.0, 95 % CI = 14.9–35.3, respectively). Pneumococcal vaccination was mostly knowledge-associated, i.e., knowing the recommendation predicted uptake (OR = 17.1, 95 % CI = 9.5–30.7). Regarding the generated KAP-scores, the practice-score reflecting vaccine related behavior such as having a vaccination record, was predictive for all vaccines considered. The knowledge-score was associated with influenza (OR = 1.3, 95 % CI = 1.0–1.6) and pneumococcal vaccination (OR = 1.2, 95 % CI = 1.0–1.5). Uniquely for influenza vaccination, the attitude-score was linked to vaccine uptake (OR = 1.1, 95 % CI = 1.0–1.1).ConclusionsOur results indicate that predictors of vaccination uptake in the elderly strongly depend on vaccine type and that scores of KAP are useful and valid to condense information from numerous individual KAP-variables. While awareness for vaccinations against influenza and tetanus is fairly high already it might have to be increased for vaccinations against pneumocoocal infections.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2784-8) contains supplementary material, which is available to authorized users.

Defining Community-Acquired Pneumonia as a Public Health Threat: Arguments in Favor from Spanish Investigators

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

“…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.…”

“…Three studies 50,51,58 that used vaccination intention as an independent variable and explored its impact on vaccination behaviour suggested that those who intended to be vaccinated were more likely to have ever undergone vaccination. Five studies 39,46,47,50,57 employed vaccination intention and vaccination behaviour as dependent variables, and two studies 44,54 adopted vaccination intention as the only outcome variable.…”

Knowledge, attitudes, and practices regarding hantavirus disease and acceptance of a vaccine trial in rural communities of southern Chile

“…The three levels of understanding obtained allow for better design of strategies or programs taking into account the community's perceptions and needs. 23,24,25,26 We hypothesized that knowledge of the disease and risk perception, together with confidence in health system would be associated with willingness to participate in a vaccine trial.…”