Socio-Psychological Factors Driving Adult Vaccination: A Qualitative Study

Abstract

BackgroundWhile immunization is one of the most effective and successful public health interventions, there are still up to 30,000 deaths in major developed economies each year due to vaccine-preventable diseases, almost all in adults. In the UK, despite comparatively high vaccination rates among ≧65 s (73%) and, to a lesser extent, at-risk ≤65 s (52%) in 2013/2014, over 10,000 excess deaths were reported the previous influenza season. Adult tetanus vaccines are not routinely recommended in the UK, but may be overly administered. Social influences and risk-perceptions of diseases and vaccines are known to affect vaccine uptake. We aimed to explore the socio-psychological factors that drive adult vaccination in the UK, specifically influenza and tetanus, and to evaluate whether these factors are comparable between vaccines.Methods20 in-depth, face-to-face interviews were conducted with members of the UK public who represented a range of socio-demographic characteristics associated with vaccination uptake. We employed qualitative interviewing approaches to reach a comprehensive understanding of the factors influencing adult vaccination decisions. Thematic analysis was used to analyze the data.ResultsParticipants were classified according to their vaccination status as regular, intermittent and non-vaccinators for influenza, and preventative, injury-led, mixed (both preventative and injury-led) and as non-vaccinators for tetanus. We present our finding around five overarching themes: 1) perceived health and health behaviors; 2) knowledge; 3) vaccination influences; 4) disease appraisal; and 5) vaccination appraisal.ConclusionThe uptake of influenza and tetanus vaccines was largely driven by participants' risk perception of these diseases. The tetanus vaccine is perceived as safe and sufficiently tested, whereas the changing composition of the influenza vaccine is a cause of uncertainty and distrust. To maximize the public health impact of adult vaccines, policy should be better translated into high vaccination rates through evidence-based implementation approaches.

Factors Affecting the Immunization Approaches of Caregivers: An Example of a Teaching and Research Hospital

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Measles cases among adolescents in southern Pakistan 2012–2015: The case for revisiting vaccination strategies

“…An additional strategy for immunizing at-risk preadolescents and young adults with no prior history of vaccination, or absence of evidence of immunity can be introduction of public awareness programs to increase risk perception among the general masses. 9 Our data has several limitations. First, we have used a secondary data source in the form of laboratory data where denominators for population are not available, and cases are passively identified based on physician requests.…”

Poor knowledge of vaccination recommendations and negative attitudes towards vaccinations are independently associated with poor vaccination uptake among adults – Findings of a population-based panel study in Lower Saxony, Germany

“…In agreement with these results, tetanus vaccination coverage was the highest among the vaccinations in our study (78%). Good knowledge of and positive attitudes towards tetanus vaccination may at least partly be associated with treatment of wounds [17]. In general, the majority of participants had positive attitudes towards vaccinations, however, the attitudes varied by specific vaccinations.…”

“…We used different questions to assess the attitudes towards vaccinations. First we asked about attitudes towards tetanus and influenza vaccination because these two vaccines are known to be perceived differently [17]. The following three questions were used: 'What is your general attitude towards vaccinations?…”