University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney, NSW, Australia.
The Sax Institute, Sydney, NSW, Australia.
Vaccine. 2024 Jun 11;42(16):3601-3606. doi: 10.1016/j.vaccine.2024.04.069. Epub 2024 May 3.
This study sought to identify the behavioural and social drivers of vaccination in 16,745 older Australians. We analysed and compared influences on COVID-19 vaccination intention and uptake using prospectively collected survey data from the Sax Institute's 45 and Up Study. Vaccination intention increased with older age (adjusted odds ratio [aOR]:1.03; 95 % confidence interval [CI]: 1.01-1.04; p = .002), a belief that the vaccine is important for the person's own health (aOR: 5.17; 95 % CI: 4.23-6.24; p < .001), is safe (aOR:2.64; 95 % CI: 2.19-3.2; p < .001), and trusted by the person (aOR:6.79; 95 % CI: 5.59-8.26 p < .001); concern about contracting COVID-19 (aOR:1.78; 95 % CI: 1.47-2.17; p < .001); having enough information about COVID-19 vaccines (aOR:1.99; 95 % CI: 1.65-2.29; p < .001); a belief that most adults will receive a COVID-19 vaccine (aOR:2.31; 95 % CI: 1.93-2.77; p < .001); and a belief that family and friends wanted the person to receive a COVID-19 vaccine (aOR:6.07; 95 % CI: 5.06-7.27; p < .001). The same factors contributed to increased vaccine uptake, with the exception of age and the belief that the person had enough information about the vaccine. Concern that the vaccine will cause a serious reaction was associated with both lower intention (aOR:0.35; 95 % CI: 0.29-0.43; p < .001) and lower uptake (aOR:0.61; 95 % CI: 0.46-0.81; p < .001) while lower intention was also associated with low decisional autonomy (aOR:0.37; 95 % CI: 0.22-0.62; p < .001). Intentions changed over time and a change towards vaccination was associated with perceptions of vaccine safety. Access barriers played a role in the non-vaccination of otherwise intending older Australians. Messaging that is adaptive to safety concerns, emphasises vaccine benefits, leverages social norms, and targets people who make decisions for older Australians may be helpful for influencing vaccination intentions and increasing vaccine uptake.
这项研究旨在确定 16745 名澳大利亚老年人接种疫苗的行为和社会驱动因素。我们使用 Sax 研究所 45 岁及以上研究前瞻性收集的调查数据，分析和比较了 COVID-19 疫苗接种意向和接种率的影响。接种意愿随年龄增长而增加（调整后的优势比[aOR]：1.03；95%置信区间[CI]：1.01-1.04；p=0.002），认为疫苗对个人自身健康很重要（aOR：5.17；95%CI：4.23-6.24；p<0.001）、安全（aOR：2.64；95%CI：2.19-3.2；p<0.001）且值得信任（aOR：6.79；95%CI：5.59-8.26 p<0.001）；担心感染 COVID-19（aOR：1.78；95%CI：1.47-2.17；p<0.001）；有足够的 COVID-19 疫苗信息（aOR：1.99；95%CI：1.65-2.29；p<0.001）；相信大多数成年人将接种 COVID-19 疫苗（aOR：2.31；95%CI：1.93-2.77；p<0.001）；以及相信家人和朋友希望个人接种 COVID-19 疫苗（aOR：6.07；95%CI：5.06-7.27；p<0.001）。同样的因素也增加了疫苗接种率，除了年龄和个人认为自己有足够疫苗信息的信念。担心疫苗会引起严重反应与较低的接种意愿（aOR：0.35；95%CI：0.29-0.43；p<0.001）和较低的接种率（aOR：0.61；95%CI：0.46-0.81；p<0.001）有关，而较低的接种意愿也与决策自主权较低有关（aOR：0.37；95%CI：0.22-0.62；p<0.001）。接种意愿随时间而变化，向接种疫苗的转变与对疫苗安全性的看法有关。获取疫苗的障碍也是原本有意愿接种的老年澳大利亚人未接种疫苗的原因之一。针对安全性问题的适应性信息、强调疫苗益处、利用社会规范以及针对为老年澳大利亚人做决策的人，可能有助于影响疫苗接种意愿并提高疫苗接种率。
