JMIR Publications

ABSTRACT

Background:

In 2024, Zhejiang Province introduced a new policy offering free influenza vaccinations to individuals aged 60 and above group. However, the vaccination willingness among the newly eligible 60-69 age group remains ambiguous in comparison to those aged 70 and older.

Objective:

This study aimed to evaluate the willingness of individuals aged ≥60 years in Zhejiang Province, China, to receive free influenza vaccines under a newly implemented policy. It further explored their sources of influenza-related health information and identified key determinants of vaccination hesitancy across age subgroups.

Methods:

A cross-sectional survey was conducted using multi-stage convenience sampling. Face-to-face interviews were administered to 7,162 eligible participants aged ≥60 years from March to May 2024. Valid responses (n=7,103; response rate: 99.18%) were analyzed via logistic regression and Kruskal-Wallis tests.

Results:

Overall vaccination willingness was 73.15%, with 11.71% refusal and 15.14% hesitancy. Key predictors of hesitancy included male gender (OR=1.273, 95% CI [1.051–1.543]), age 60–69 (OR=1.463, 95% CI [1.060–2.020]), corporate employment (OR=0.754, 95% CI [0.580–0.980]), and absence of chronic diseases (OR=2.062, 95% CI [1.438–2.955]). The 60–69 age group demonstrated lower awareness of the free policy (H=61.247, P<.001) but higher engagement with social media (WeChat: H=345.443; TikTok: H=294.658; P<.001) for health information.

Conclusions:

Despite high willingness, knowledge gaps persist, particularly among younger elderly (60–69 years). Targeted dissemination of policy information via social media platforms (e.g., WeChat, TikTok) and community-driven campaigns is recommended to enhance vaccination uptake.