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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE (Open Access)

Investigating behaviours and attitudes regarding recommended vaccination in adults 50 years and above in Australia

Amalie Dyda A * , Harriet Lawford B , Colleen L. Lau B and Kim Sampson C
+ Author Affiliations
- Author Affiliations

A School of Public Health, The University of Queensland, Brisbane, Qld 4006, Australia.

B Centre for Clinical Research, The University of Queensland, Brisbane, Qld 4006, Australia.

C Immunisation Coalition, Melbourne, Vic 3004, Australia.

* Correspondence to: a.dyda@uq.edu.au

Australian Journal of Primary Health 30, PY24055 https://doi.org/10.1071/PY24055
Submitted: 8 May 2024  Accepted: 8 November 2024  Published: 29 November 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

Vaccination is important for adults to reduce the morbidity and mortality associated with infectious diseases. In Australia, many vaccines are recommended and funded under the Australian National Immunisation Program. However, a number of vaccines are recommended for adults but not funded. This study aimed to explore factors impacting uptake of recommended vaccines in adults aged ≥50 years in Australia.

Methods

An online cross-sectional survey was conducted from the general population aged ≥50 years. The survey was distributed via a market research company using a convenience sample. Data were analysed descriptively, and logistic regression was used to investigate associations between participant characteristics and vaccine uptake.

Results

A total of 1012 individuals completed the survey. The majority (67.4%) of participants reported it was important for adults to receive recommended vaccines. More than half (59.6%) felt that vaccination was more important for children. Over 60% of participants reported they knew the vaccines that they should receive. The primary reason reported for not receiving a vaccine was, ‘I do not believe it is necessary’. Being aged ≥66 years was significantly associated with uptake of influenza, pertussis, herpes zoster, and pneumococcal vaccines. Being female was associated with higher uptake for most vaccines, except for pneumococcal vaccine, where no significant association was found.

Conclusions

The importance of vaccination and risks associated with lack of vaccination need to be highlighted to this population. Recommendations from healthcare professionals continue to be one of the most important facilitators for uptake. Overall, adults reported they are unlikely to pay for recommended vaccines, making increasing uptake of these vaccines difficult.

Keywords: adults, coverage, herpes zoster, infectious diseases, influenza, pneumococcal, uptake, vaccination.

References

APMI Partners (2023) Available at https://www.apmipartners.com/

Australian Bureau of Statistics (2021–2022) Patient experiences. Available at https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release

Australian Government Department of Health and Aged Care (2023) National immunisation program schedule. Available at https://www.health.gov.au/topics/immunisation/when-to-get-vaccinated/national-immunisation-program-schedule

Australian Institute of Health and Welfare (2011) 2009 Adult vaccination survey: summary results. AIHW, Canberra.

Australian Technical Advisory Group on Immunisation (ATAGI) (2022) Australian immunisation handbook. Available at https://www.health.gov.au/resources/publications/the-australian-immunisation-handbook

Bayliss J, Randhawa R, Oh K-B, Kandeil W, Jenkins VA, Turriani E, Nissen M (2021) Perceptions of vaccine preventable diseases in Australian healthcare: focus on pertussis. Human Vaccines & Immunotherapeutics 17(2), 344-350.
| Crossref | Google Scholar | PubMed |

Bennett N, Morris B, Malloy MJ, Lim L-L, Watson E, Bull A, Sluggett J, Worth LJ (2023) An evaluation of influenza, pneumococcal and herpes zoster vaccination coverage in Australian aged care residents, 2018 to 2022. Infection, Disease & Health 28(4), 253-258.
| Crossref | Google Scholar | PubMed |

Briggs L, Fronek P, Quinn V, Wilde T (2019) Perceptions of influenza and pneumococcal vaccine uptake by older persons in Australia. Vaccine 37(32), 4454-4459.
| Crossref | Google Scholar | PubMed |

Cheng AC, Holmes M, Dwyer DE, Senanayake S, Cooley L, Irving LB, Simpson G, Korman T, Macartney K, Friedman ND, Wark P, Howell A, Blyth CC, Crawford N, Buttery J, Bowler S, Upham JW, Waterer GW, Kotsimbos T, Kelly PM (2019) Influenza epidemiology in patients admitted to sentinel Australian hospitals in 2018: the Influenza Complications Alert Network (FluCAN). Communicable Diseases Intelligence 2018, 43.
| Crossref | Google Scholar |

Churchill BF, Henkhaus LE (2022) The roles of cost and recommendations in driving vaccine take-up: evidence from the herpes zoster vaccine for shingles prevention. American Journal of Health Economics 9(4), 523-551.
| Crossref | Google Scholar |

Clarke M, Thomas N, Giles L, Marshall H (2015) Community awareness and predictors of uptake of pertussis booster vaccine in South Australian adults. Vaccine 33(51), 7337-7343.
| Crossref | Google Scholar | PubMed |

Dash R, Agrawal A, Nagvekar V, Lele J, Di Pasquale A, Kolhapure S, Parikh R (2019) Towards adult vaccination in India: a narrative literature review. Human Vaccines & Immunotherapeutics 16(4), 991-1001.
| Crossref | Google Scholar | PubMed |

Dey A, Rashid H, Sharma K, Phillips A, Li-Kim-Moy J, Manocha R, Macartney K, Beard F (2022) General practitioner knowledge gaps regarding live attenuated zoster vaccination of immunocompromised individuals: an ongoing concern? Australian Journal of General Practice 51(7), 529-534.
| Crossref | Google Scholar | PubMed |

Dyda A, Karki S, Hayen A, Macintyre CR, Menzies R, Banks E, Kaldor JM, Liu B (2016) Influenza and pneumococcal vaccination in Australian adults: a systematic review of coverage and factors associated with uptake. BMC Infectious Diseases 16, 515.
| Crossref | Google Scholar |

Eiden AL, Barratt J, Nyaku MK (2022) Drivers of and barriers to routine adult vaccination: a systematic literature review. Human Vaccines & Immunotherapeutics 18(6), 2127290.
| Crossref | Google Scholar | PubMed |

Gonzalez-Chica D, Frank O, Edwards J, Hoon E, de Oliveira Bernardo C, Knieriemen A, Stocks N (2024) Effectiveness of patient reminders on influenza vaccination coverage among adults with chronic conditions: A feasibility study in Australian general practices. Preventive Medicine 184, 107983.
| Crossref | Google Scholar |

Holden CA, Jolley DJ, Mclachlan RI, Pitts M, Cumming R, Wittert G, Handelsman DJ, De Kretser DM (2006) Men in australia telephone survey (MATeS): predictors of men’s help-seeking behaviour for reproductive health disorders. Medical Journal of Australia 185(8), 418-422.
| Crossref | Google Scholar | PubMed |

Hull B, Hendry A, Dey A, Macartney K, Mcintyre P, Beard F (2019) Exploratory analysis of the first 2 years of adult vaccination data recorded on AIR. National Centre for Immunisation Research and Surveillance (NCIRS).

Hull B, Hendry A, Dey A, Brotherton J, Macartney K, Beard F (2022) Annual immunisation coverage report 2021. National Centre for Immunisation Research and Surveillance.

Khandaker G, Chapman G, Khan A, Al Imam MH, Menzies R, Smoll N, Walker J, Kirk M, Wiley K (2024) Evaluating pilot implementation of ‘PenCS Flu Topbar’ app in medical practices to improve national immunisation program–funded seasonal influenza vaccination in Central Queensland, Australia. Influenza and Other Respiratory Viruses 18, e13280.
| Crossref | Google Scholar | PubMed |

King JP, Mclean HQ, Belongia EA (2018) Validation of self-reported influenza vaccination in the current and prior season. Influenza and Other Respiratory Viruses 12(6), 808-813.
| Crossref | Google Scholar | PubMed |

Kolobova I, Nyaku MK, Karakusevic A, Bridge D, Fotheringham I, O’Brien M (2022) Vaccine uptake and barriers to vaccination among at-risk adult populations in the US. Human Vaccines & Immunotherapeutics 18(5), 2055422.
| Crossref | Google Scholar | PubMed |

Lin J, Wood JG, Bernardo C, Stocks NP, Liu B (2020) Herpes zoster vaccine coverage in Australia before and after introduction of a national vaccination program. Vaccine 38(20), 3646-3652.
| Crossref | Google Scholar | PubMed |

Lu P-J, Srivastav A, Santibanez TA, Christopher Stringer M, Bostwick M, Dever JA, Stanley Kurtz M, Williams WW (2017) Knowledge of influenza vaccination recommendation and early vaccination uptake during the 2015–16 season among adults aged ≥18 years – United States. Vaccine 35(34), 4346-4354.
| Crossref | Google Scholar | PubMed |

MacDougall DM, Halperin BA, MacKinnon-Cameron D, Li L, McNeil SA, Langley JM, Halperin SA (2015) The challenge of vaccinating adults: attitudes and beliefs of the Canadian public and healthcare providers. BMJ Open 5, e009062.
| Crossref | Google Scholar | PubMed |

Martin S, Haren M, Taylor A, Middleton S, Wittert G (2007) Cohort profile: the florey adelaide male ageing study (FAMAS). International Journal of Epidemiology 36(2), 302-306.
| Crossref | Google Scholar | PubMed |

Ridda I, Lindley IR, Gao Z, McIntyre P, MacIntyre CR (2008) Differences in attitudes, beliefs and knowledge of hospital health care workers and community doctors to vaccination of older people. Vaccine 26(44), 5633-5640.
| Crossref | Google Scholar | PubMed |

Scheifele DW, Ward BJ, Halperin SA, Mcneil SA, Crowcroft NS, Bjornson G (2014) Approved but non-funded vaccines: accessing individual protection. Vaccine 32(7), 766-770.
| Crossref | Google Scholar | PubMed |

Smith R, Hubers J, Farraye FA, Sampene E, Hayney MS, Caldera F (2021) Accuracy of self-reported vaccination status in a cohort of patients with inflammatory bowel disease. Digestive Diseases and Sciences 66(9), 2935-2941.
| Crossref | Google Scholar | PubMed |

StataCorp (2023) Stata statistical software: release 18. StataCorp LLC, College Station, TX, USA.

Trent MJ, Salmon DA, MacIntyre CR (2021) Using the health belief model to identify barriers to seasonal influenza vaccination among Australian adults in 2019. Influenza and Other Respiratory Viruses 15(5), 678-687.
| Crossref | Google Scholar | PubMed |

Wang Q, Yang L, Li L, Liu C, Jin H, Lin L (2023) Willingness to vaccinate against herpes zoster and its associated factors across who regions: global systematic review and meta-analysis. JMIR Public Health Surveill 9, e43893.
| Crossref | Google Scholar |

Wheelock A, Parand A, Rigole B, Thomson A, Miraldo M, Vincent C, Sevdalis N (2014) Socio-psychological factors driving adult vaccination: a qualitative study. PLoS ONE 9, e113503.
| Crossref | Google Scholar | PubMed |

Wong LP, Lee HY, Alias H, Zimet G, Liu T, Lin Y, Hu Z (2024) Cost-based COVID-19 vaccination and willingness to pay: a post-pandemic review. Human Vaccines & Immunotherapeutics 20(1), 2313860.
| Crossref | Google Scholar |

Yeung MPS, Lam FLY, Coker R (2016) Factors associated with the uptake of seasonal influenza vaccination in adults: a systematic review. Journal of Public Health 38(4), 746-753.
| Crossref | Google Scholar | PubMed |