AUTHOR=Wei Lu , Zeng Wu , Huang Yangyang , Ye Guoxin , Chen Ying , Yang Ling , Cai Yuyang 

TITLE=COVID-19 vaccination coverage and its cognitive determinants among older adults in Shanghai, China, during the COVID-19 epidemic

JOURNAL=Frontiers in Public Health

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1163616

DOI=10.3389/fpubh.2023.1163616

ISSN=2296-2565

ABSTRACT=<sec><title>Objectives</title><p>This study aimed to examine the coverage of coronavirus disease 2019 (COVID-19) vaccination and its cognitive determinants among older adults.</p></sec><sec><title>Methods</title><p>A cross-sectional study was conducted using a questionnaire to conduct a survey among 725 Chinese older adults aged 60 years and above in June 2022, 2 months after the mass COVID-19 outbreak in Shanghai, China. The questionnaire covered demographic characteristics, COVID-19 vaccination status, internal risk perception, knowledge, and attitude toward the efficacy and safety of COVID-19 vaccines.</p></sec><sec><title>Results</title><p>The vaccination rate was 78.3% among the surveyed individuals. Self-reported reasons for unwillingness to get vaccinated (multiple selections) were “concerns about acute exacerbation of chronic diseases after vaccination (57.3%)” and “concerns regarding vaccine side effects (41.4%).” Compared to the unvaccinated group, the vaccinated group tended to have a higher score in internal risk perception (<italic>t</italic> = 2.64, <italic>P</italic> &lt; 0.05), better knowledge of COVID-19 vaccines (<italic>t</italic> = 5.84, <italic>P</italic> &lt; 0.05), and a more positive attitude toward the efficacy and safety of COVID-19 vaccines (<italic>t</italic> = 7.92, <italic>P</italic> &lt; 0.05). The path analysis showed that the cognitive effect on vaccination behavior is relatively large, followed by the internal risk perception, and then the attitude toward COVID-19 vaccines. The more knowledgeable the participants were about COVID-19 vaccines, the more likely they were to receive the COVID-19 vaccines. In the multivariate logistic regression, the increased coverage of COVID-19 vaccination was associated with reduced age (OR = 0.53 95% CI 0.43–0.66, <italic>P</italic> &lt; 0.001), being a resident in other places than Shanghai (OR = 0.40, 95% CI 0.17–0.92, <italic>P</italic> &lt; 0.05), a shorter time of lockdown (OR = 0.33, 95% CI 0.13–0.83, <italic>P</italic> &lt; 0.05), a history of other vaccines (OR = 2.58, 95% CI 1.45–4.60, <italic>P</italic> &lt; 0.01), a fewer number of chronic diseases (OR = 0.49, 95% CI 0.38–0.62, <italic>P</italic> &lt; 0.001), better knowledge about COVID-19 vaccines (OR = 1.60, 95% CI 1.17–2.19, <italic>P</italic> &lt; 0.01), and a positive attitude toward COVID-19 vaccines (OR = 9.22, 95% CI 4.69–18.09, <italic>P</italic> &lt; 0.001).</p></sec><sec><title>Conclusion</title><p>Acquiring accurate knowledge and developing a positive attitude toward COVID-19 vaccines are important factors associated with COVID-19 vaccination. Disseminating informed information on COVID-19 vaccines and ensuring efficacious communication regarding their efficacy and safety would enhance awareness about COVID-19 vaccination among older adults and consequently boost their vaccination coverage.</p></sec>