Mapping Behavioral and Social Drivers of Influenza Vaccine Uptake in Older Adults: A Scoping Review.

Influenza vaccination plays a crucial role in reducing morbidity and mortality among older adults; however, uptake remains suboptimal, particularly in the post-COVID-19 pandemic. In many settings, countries have not recovered their influenza vaccine coverage rates to the same level as pre-COVID. Therefore, this scoping review systematically identified the behavioral and social drivers (BeSD) influencing influenza vaccination among older adults using the BeSD framework. : A systematic search across five databases included quantitative, qualitative, and mixed-methods studies involving individuals aged 60 years and older. Data were charted across four BeSD domains: thinking and feeling, social processes, motivation, and practical issues. : Thirty-nine studies from 24 countries were included. Key barriers encompassed safety concerns, misinformation, financial burdens, logistical challenges, and cultural and language barriers. While motivation was positively associated with vaccination intentions, the transition from intention to behavior remains underexplored, and practical issues have received comparatively limited research attention. : These findings underscore the need for multifaceted, behaviorally informed interventions and greater inclusion of under-resourced settings to support equitable influenza vaccination strategies for healthy aging.