tetano
Editor, Senior Moderator
JMIR Hum Factors
. 2025 Sep 15:12:e73940.
doi: 10.2196/73940. Impact of a Free Influenza Vaccination Policy on Older Adults in Zhejiang, China: Cross-Sectional Survey of Vaccination Willingness and Determinants
Yusui Zhao[SUP] 1 [/SUP], Jinhang Xu[SUP] 1 [/SUP], Xuehai Zhang[SUP] 1 [/SUP], Yue Xu[SUP] 1 [/SUP], Xiaotong Yan[SUP] 1 [/SUP], Shaofan Ren[SUP] 1 [/SUP], Lixin Wang[SUP] 1 [/SUP]
Affiliations
Background: In 2024, Zhejiang Province introduced a new policy offering free influenza vaccinations to individuals aged 60 years and older. However, the vaccination willingness among the newly eligible 60-69 years age group remains ambiguous in comparison to those aged 70 years 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 multistage convenience sampling via on-site questionnaires. Structured questionnaires were administered to 7162 eligible participants aged ≥60 years from March to May 2024. Valid responses (n=7103; response rate: 99.18%) were analyzed via logistic regression and Kruskal-Wallis tests.
Results: Overall vaccination willingness was 73.15% (5196/7103), with 11.71% (832/7103) refusal and 15.14% (1075/7103) hesitancy. Key predictors of hesitancy included male gender (odds ratio [OR] 1.27, 95% CI 1.05-1.54), ages 60-69 years (OR 1.46, 95% CI 1.06-2.02), corporate employment (OR 0.75, 95% CI 0.58-0.98), and absence of chronic diseases (OR 2.06, 95% CI 1.44-2.96). The 60-69 year age group demonstrated lower awareness of the free policy (61.9% vs 73.72% in the ≥70 years group; H=61.25, P<.001) but higher engagement with social media (WeChat [Tencent Holdings Limited]: H=345.44; TikTok [ByteDance Ltd]: H=294.66; P<.001) for health information.
Conclusions: Despite high willingness, knowledge gaps persist, particularly among adults aged 60-69 years. Targeted dissemination of policy information via social media platforms (eg, WeChat and TikTok) and community-driven campaigns is recommended to enhance vaccination uptake. This approach may serve as a model for regions implementing similar policies. Future studies should track actual vaccination uptake postpolicy and explore artificial intelligence-driven social media interventions to boost engagement.
Keywords: China; health policy; influenza vaccine; older adults; vaccination willingness.
. 2025 Sep 15:12:e73940.
doi: 10.2196/73940. Impact of a Free Influenza Vaccination Policy on Older Adults in Zhejiang, China: Cross-Sectional Survey of Vaccination Willingness and Determinants
Yusui Zhao[SUP] 1 [/SUP], Jinhang Xu[SUP] 1 [/SUP], Xuehai Zhang[SUP] 1 [/SUP], Yue Xu[SUP] 1 [/SUP], Xiaotong Yan[SUP] 1 [/SUP], Shaofan Ren[SUP] 1 [/SUP], Lixin Wang[SUP] 1 [/SUP]
Affiliations
- PMID: 40953309
- PMCID: PMC12435753
- DOI: 10.2196/73940
Background: In 2024, Zhejiang Province introduced a new policy offering free influenza vaccinations to individuals aged 60 years and older. However, the vaccination willingness among the newly eligible 60-69 years age group remains ambiguous in comparison to those aged 70 years 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 multistage convenience sampling via on-site questionnaires. Structured questionnaires were administered to 7162 eligible participants aged ≥60 years from March to May 2024. Valid responses (n=7103; response rate: 99.18%) were analyzed via logistic regression and Kruskal-Wallis tests.
Results: Overall vaccination willingness was 73.15% (5196/7103), with 11.71% (832/7103) refusal and 15.14% (1075/7103) hesitancy. Key predictors of hesitancy included male gender (odds ratio [OR] 1.27, 95% CI 1.05-1.54), ages 60-69 years (OR 1.46, 95% CI 1.06-2.02), corporate employment (OR 0.75, 95% CI 0.58-0.98), and absence of chronic diseases (OR 2.06, 95% CI 1.44-2.96). The 60-69 year age group demonstrated lower awareness of the free policy (61.9% vs 73.72% in the ≥70 years group; H=61.25, P<.001) but higher engagement with social media (WeChat [Tencent Holdings Limited]: H=345.44; TikTok [ByteDance Ltd]: H=294.66; P<.001) for health information.
Conclusions: Despite high willingness, knowledge gaps persist, particularly among adults aged 60-69 years. Targeted dissemination of policy information via social media platforms (eg, WeChat and TikTok) and community-driven campaigns is recommended to enhance vaccination uptake. This approach may serve as a model for regions implementing similar policies. Future studies should track actual vaccination uptake postpolicy and explore artificial intelligence-driven social media interventions to boost engagement.
Keywords: China; health policy; influenza vaccine; older adults; vaccination willingness.