Drivers and Barriers for Vaccination among the Elderly - A Qualitative Study in Sweden

Background

One of the most effective interventions to prevent infectious diseases is vaccination, and for the elderly, the influenza vaccine can prevent severe illness and death. Immunizations are especially important with increasing age, and an increased risk of severe COVID-19 has been documented for persons living in long-term care facilities for the elderly. This study aims to understand drivers and barriers to vaccination among the elderly population.

Methods

A qualitative study used in-depth interviews guided by the WHO’s Behavioural and Social Drivers (BeSD) framework. Participants included 15 adults aged 65 and older. Interviews were audio-recorded, transcribed, and analysed thematically (Clarke & Braun).

Results

Findings were organized according to the BeSD framework’s four themes: Thinking and feeling: Elderly participants did not fear influenza or COVID-19, but rather demonstrated respect for infectious diseases, drawing on personal experiences of severe childhood illnesses that had been eliminated or drastically decreased in Sweden. Social processes: Trusting relationships between nurses and elderly in care facilities fostered trust in the vaccine information and vaccinations.

Motivation

The elderly participants exhibited positive attitudes toward vaccination and accepted the vaccine provided by home-care facilities. Practical issues: Vaccination was highly accessible in the home-care facilities, with nurses facilitating on-site administration. However, barriers emerged prior to when the participants lived independently, particularly the physical challenge of traveling to primary care clinics.

Conclusions

Trust and accessibility are critical for vaccination uptake. On-site vaccination in home-care facilities is effective, but barriers persist for those living independently.

Key messages

• Trust in healthcare and on-site vaccination boost uptake among elderly in care.

• Using behavioural models is essential to uncover barriers and drivers for vaccinations.