Accepted for/Published in: JMIR Formative Research
Date Submitted: May 31, 2022
Date Accepted: Jan 18, 2023
Date Submitted to PubMed: Jan 24, 2023
Understanding Drivers of Vaccine Hesitancy among Older Adults in Jiangsu Province, China: A Cross-sectional Survey in the COVID-19 pandemic
ABSTRACT
Background:
Older adults are particularly at risk from infectious diseases, including serve complications, hospitalization, and death. The drivers behind vaccine hesitancy among older adults remain unclear.
Objective:
This study aimed to examine the role of socio-demographics as moderating contributors to older adults’ vaccine hesitancy based on the 3Cs model.
Methods:
A cross-sectional questionnaire survey was conducted in China between June 1, 2021, and July 20, 2021. Older adults (above 60 years) were recruited using a stratified sampling method. Vaccine hesitancy was setting influenced by confidence, complacency, and convenience in the model. Socioeconomic status and vaccination history processed through the item parceling method were used to moderate the association between the 3Cs and hesitancy. Hierarchical regression analyses and structural equation modeling were used to test the validity of the new framework. We performed 5000 trials of bootstrapping to calculate the pathway’s coefficients.
Results:
A total of 1341 older adults (response rate: 87%) participated. The age was 71.3 ± 5.4 years old and 44.7% of participants were men. The direct effects of confidence, convenience, and complacency on vaccine hesitancy were 0.967, 0.458, and 0.301, respectively. Socioeconomic status weakened the positive effect of low complacency (β = -0.065, P = .029) on low vaccine hesitancy. Coronavirus disease 2019 (COVID-19) vaccination history negatively moderated the positive association between confidence (β = -0.071, P = .017) and lower vaccine hesitancy. Other vaccination histories had no moderating effect on the 3Cs dimensions (p confidence = .656, p convenience = .95, and p complacency = .060).
Conclusions:
Our study identified that confidence was the more influential dimension in reducing vaccine hesitancy among older adults, and it had a substitution relationship with COVID-19 vaccination history. Socioeconomic status had a substitution relationship with less complacency, which provided an available pathway for mitigating older adults’ vaccine hesitancy.
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