Older adults' vaccine hesitancy: Psychosocial factors associated with influenza, pneumococcal, and shingles vaccine uptake

Nicholls, Louise A. Brown; Gallant, Allyson; Cogan, Nicola; Rasmussen, Susan; Young, David; Williams, Lynn

doi:10.1016/j.vaccine.2021.04.062

Cited by 76 publications

(75 citation statements)

References 38 publications

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“…Considering up to 90% vaccine uptake may be required to achieve herd immunity against COVID-19 [ 13 ], it is worth highlighting that vaccine uptake among this priority population has been driven by multiple personal and social factors. In those that remain hesitant towards vaccination against COVID-19, it may be beneficial to emphasise the broader societal and environmental benefits of vaccination in addition to the personal health benefits, bearing in mind specific disease risks [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Among factors affecting older adults’ vaccine uptake, a low sense of collective responsibility, preference for natural immunity, distrust of commercial vaccination companies and high levels of information seeking have been identified as predictors of vaccine hesitancy [ 19 ]. However, while a sense of collective responsibility has been identified as a predictor of older adults’ uptake of a range of vaccines (i.e.…”

Section: Introductionmentioning

confidence: 99%

“…However, while a sense of collective responsibility has been identified as a predictor of older adults’ uptake of a range of vaccines (i.e. influenza, pneumococcal, and shingles vaccines), concerns about profiteering predicted lack of uptake of the pneumococcal and shingles vaccines, whose uptake was considerably lower than the influenza vaccine [ 19 ]. Overall, this suggests that understanding of disease risk and vaccine benefits, along with the broader psychosocial factors specifically associated with uptake, vary by vaccine.…”

Section: Introductionmentioning

confidence: 99%

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Changes in attitudes to vaccination as a result of the COVID-19 pandemic: A longitudinal study of older adults in the UK

et al. 2021

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Background The rapid development of COVID-19 vaccines has brought an unprecedented focus on public attitudes to vaccines, with intention to accept a COVID-19 vaccine fluctuating during the pandemic. However, it is unclear how the pandemic may influence attitudes and behaviour in relation to vaccines in general. The aim of the current study is to examine older adults’ changes in vaccination attitudes and behaviour over the first year of the pandemic. Methods In February-March 2020 (before the first COVID-19 national lockdown in the UK), 372 older adults (aged 65+) provided sociodemographic information, self-reported influenza vaccine uptake, and completed two measures of vaccination attitudes: the 5C scale and the Vaccination Attitudes Examination Scale. One-year later, following rollout of COVID-19 vaccines to older adults, participants provided information on their COVID-19 and influenza vaccine uptake in the previous 12 months, and completed the 5C and VAX scales again. Paired samples t-tests were used to examine changes in vaccination attitudes over time. Results Almost all participants (98.7%) had received at least one dose of a COVID-19 vaccine, and a significant increase in influenza uptake was identified (83.6% in 2020 to 91.6% in 2021). Complacency, mistrust of vaccine benefit, concerns about commercial profiteering, and constraints to vaccination had significantly decreased between Time 1 and Time 2, and collective responsibility had significant increased. However, calculation and worries about unforeseen future effects had increased, indicating that participants now perceived higher risks related to vaccination and were taking a more deliberative information-seeking approach. Conclusion The results show significant changes in vaccination attitudes across the pandemic. These changes suggest that while older adults became less complacent about the importance of vaccines, concerns about potential risks associated with vaccination increased. It will be important for public health communication to address these concerns for all vaccines offered to this group.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Changes in attitudes to vaccination as a result of the COVID-19 pandemic: A longitudinal study of older adults in the UK

et al. 2021

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“…Comparing other vaccination rates to those of influenza is not without precedent. Nicholls et al found in their comparison of influenza pneumococcal disease and shingles that interventions targeted towards older people would be more effective if they were vaccine specific and also emphasized the risks and benefits of vaccination to the individual and the community [4]. Similarly, Kwok et al conducted a study on the association between influenza vaccination uptake with COVID-19 vaccination intention in nurses during the 2 of 14 early phase of the pandemic [5].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and Historic Influenza Vaccinations in the United States: A Comparative Analysis

Mirpuri

Rovin

2021

Vaccines

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The COVID-19 vaccination effort is a monumental global challenge. Recognizing and addressing the causes of vaccine hesitancy will improve vaccine uptake. The primary objective of this study was to compare the COVID-19 vaccination rates in US counties to historical vaccination rates for influenza in persons aged 65 and older. The secondary objective was to identify county-level demographic, socioeconomic, and political factors that influence vaccination rates. County level data were obtained from publicly available databases for comparison and to create predictive models. Overall, in US counties the COVID-19 vaccination rate exceeded influenza vaccination rates amongst those aged 65 or older (69.4.0% vs. 44%, p < 0.0001). 2690 (83.4%) of 3224 counties had vaccinated 50% or more of their 65 and older residents in the first seven months of the COVID-19 vaccination roll out. There were 467 (14.5%) of 3223 counties in which the influenza vaccination rate exceeded the COVID-19 vaccination rate. Most of these counties were in the Southern region, were considered politically “red” and had a significantly higher non-Hispanic Black resident population (14.4% vs. 8.2%, p < 0.0001). Interventions intended to improve uptake should account for nuances in vaccine access, confidence, and consider factual social media messaging, especially in vulnerable counties.

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“…Across all subscales, higher scores indicate greater cognitive difficulty. The MASQ has been shown to be reliable (Cronbach's α = 0.92; > 0.70 for all subscales; Seidenberg et al, 1994) and has been used across a variety of psychological and clinical contexts, including with older adults (e.g., Judges et al, 2017;McDonald et al, 2017;Nicholls et al, 2021).…”

Section: Measure Of Cognitive Difficultiesmentioning

confidence: 99%

Adult Aging Moderates the Relationship Between Trait Cognitive Anxiety and Subjective Everyday Cognitive Difficulties

et al. 2021

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The present aim was to determine, across the adult lifespan, the extent to which different dimensions of trait anxiety might affect subjective cognitive difficulties in everyday life. Following Attentional Control Theory (ACT; Eysenck et al., 2007), we predicted that trait anxiety would have a greater effect on attention and verbal abilities than on visual abilities. We also expected trait cognitive anxiety to exhibit more robust relationships with cognition than trait somatic anxiety. Importantly, we predicted that effects of anxiety would be greater in older adults, in line with the Strength and Vulnerability Integration model (SAVI; Charles, 2010). The sample comprised 286 United Kingdom-based adults aged 18–93 years. Participants completed self-report measures of trait cognitive and somatic anxiety (the State-Trait Inventory for Cognitive and Somatic Anxiety; STICSA, Ree et al., 2008) and everyday cognitive difficulties (the Multiple Abilities Self-Report Questionnaire; MASQ, Seidenberg et al., 1994). Moderated regression models were constructed, including trait cognitive or somatic anxiety as a predictor of cognitive difficulties, and age as the moderator variable. Covariates included depression, stress (the Depression Anxiety Stress Scales—short form; DASS-21, Lovibond and Lovibond, 1995), gender, current mental health treatment status, and physical health status. When cognitive anxiety was the predictor variable, somatic anxiety was also included as a covariate, and vice-versa. Trait cognitive anxiety and age interacted to predict all MASQ subscales other than visual-perceptual ability. Difficulties with attention, verbal memory, and language abilities were significantly greater at higher levels of anxiety for all age groups, with the effect greatest in older adults. Difficulties with visual-spatial memory were significantly greater at higher levels of anxiety in middle-aged and older adults only. Higher trait somatic anxiety predicted difficulties with verbal memory and language ability independently of age, and interacted with age to predict language difficulties. Interestingly, age also significantly predicted less subjective difficulty with attention, independently of anxiety level. The results show that trait cognitive and somatic anxiety are both related to subjective, everyday cognitive difficulties. However, effects of trait cognitive anxiety are more robust across cognitive domains and tend to increase, or first appear, over the course of the adult lifespan.

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Older adults' vaccine hesitancy: Psychosocial factors associated with influenza, pneumococcal, and shingles vaccine uptake

Cited by 76 publications

References 38 publications

Changes in attitudes to vaccination as a result of the COVID-19 pandemic: A longitudinal study of older adults in the UK

Changes in attitudes to vaccination as a result of the COVID-19 pandemic: A longitudinal study of older adults in the UK

COVID-19 and Historic Influenza Vaccinations in the United States: A Comparative Analysis

Adult Aging Moderates the Relationship Between Trait Cognitive Anxiety and Subjective Everyday Cognitive Difficulties

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