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Observational Study
. 2025 May 30;104(22):e42597.
doi: 10.1097/MD.0000000000042597.

Determinants of pneumococcal vaccination behavior among elderly people aged ≥60 years in Jiangxi, China

Han Zhao  1   2   3 , Shicheng Guo  1 , Jie Liu  1 , Li Li  4 , Jing Wu  1
Affiliations
Observational Study

Determinants of pneumococcal vaccination behavior among elderly people aged ≥60 years in Jiangxi, China

Han Zhao et al. Medicine (Baltimore). .

Abstract

The aim of this study was to explore factors influencing pneumococcal vaccination in people aged ≥ 60 years. We used a non-matched case-control study design to collect data on PPSV23 administration and pneumococcal disease/PPSV23 cognition and other factors among ≥ 60-year-olds in 2 prefectures of Jiangxi Province from January 2022 to December 2023. We compared the composition of each factor between vaccinated and non-vaccinated subjects, identified factors influencing pneumococcal vaccination using a logistic regression model and evaluated the model predictive ability by using ROC curve. This study included 212 subjects who received PPSV23 and 213 subjects who did not receive. The analysis of knowledge and attitude of pneumococcal disease/PPSV23 showed that the proportion of awareness ranged from 13.21% to 84.43% in the vaccinated group and from 13.62% to 67.14% in the unvaccinated group, and the proportion of positive attitudes ranged from 39.15% to 89.15% in the vaccinated group and 30.52% to 63.38% in the unvaccinated group. Multivariate stepwise logistic regression analysis showed that urban residents (aOR = 2.603, 95% CI: 1.236-5.481), PPSV23 vaccination history of surrounding people (aOR = 8.152, 95% CI: 4.832-13.751), healthcare workers recommended PPSV23 (aOR = 2.960, 95% CI: 1.763-4.968), acceptable vaccine price at ≥ 200 yuan (aOR = 3.061, 95% CI: 1.461-6.412), and positive attitude toward pneumococcal disease/PPSV23 (aOR = 4.636, 95% CI: 1.492-14.411) promoted PPSV23 vaccination of subjects. The pneumococcal vaccination of ≥ 60-year-olds in Jiangxi was mainly influenced by PPSV23 vaccination history of surrounding people, pneumococcal disease/PPSV23 cognition, and vaccine price. It is suggested that health education on knowledge about pneumococcal disease/PPSV23 be strengthened for the elderly.

Keywords: elderly people; influence factor; pneumococcal vaccine; vaccination behavior.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Stepwise logistic regression model ROC curve. The figure illustrates the ROC curve for the multivariate stepwise logistic regression model used in the study. The x-axis represents specificity, while the y-axis indicates 1-sensitivity. The AUC is a measure of the model’s predictive performance, with higher values indicating better discriminative ability. AUC = area under the curve, CI = confidence interval.
Figure 2.
Figure 2.
Top reasons for not vaccinated with PPSV23. PPSV23 = 23-valent pneumococcal polysaccharide vaccine.
See this image and copyright information in PMC

References

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