COVID-19 vaccine hesitancy among the Chinese elderly: A multi-stakeholder qualitative study

ABSTRACT

The United Nations reported that the mortality risk of Corona Virus Disease 2019 (COVID-19) is five times higher in the elderly than the global average. Although the COVID-19 vaccine effectively prevents infections and reduce mortality among the elderly, vaccine hesitancy among the Chinese elderly poses a significant threat. This study, utilizing the “Confidence, Convenience and Complacency (3 Cs)” vaccine hesitancy model, aimed to explore factors contributing to vaccine hesitancy among the Chinese elderly and assess national countermeasures and potential improvement approaches. Thirteen elderly with vaccine hesitancy and eleven vaccine-related staff participated in semi-structured interviews. Thematic analysis revealed three key determinants of vaccine hesitancy among the elderly: perceived low threat of COVID-19, lack of confidence in COVID-19 vaccine, and poor accessibility to vaccination. China has implemented strategies, including advocacy through diverse channels, joint multi-sectoral promotion vaccination, and enhancing ongoing vaccination services. Recommendations from the vaccine-related staff emphasize improving vaccine awareness among the elderly, and prioritizing the vaccination environment and process. The study underscores the importance of targeted vaccination promotion programs addressing hesitation reasons to improve vaccination rates. Furthermore, existing countermeasures can serve as a foundation for enhancing vaccination strategies, including improved publicity, administration, and management approaches.

KEYWORDS:

• Vaccine hesitancy
• Corona Virus Disease 2019
• factors
• countermeasures and approaches
• the elderly
• qualitative study

Acknowledgments

We would like to thank the HER Team from Xiangya school of public health in Central South University including Jiale Peng and Yuhua Qin for contacting the respondents to collaborate with the data collection.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Wenjie Gong conceived the study. Xiaoyu Li and Yanping Bai were responsible for the textual analysis and writing of the articles under the guidance of Wenjie Gong, while Xiaoyu Li and Yunshan Bai was responsible for conducting the interviews and transcribing the audio recordings of the interviews. Xiaoyu Li and Yanping Bai helped with the revision of the interview outlines and questionnaires, and were responsible for contacting the respondents to collaborate with the data collection. Lijun Weng was responsible for literature searching, data quality supervision and manuscript preparation. All authors approved the final draft. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. Wenjie Gong is the guarantor of the study.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website at https://doi.org/10.1080/21645515.2024.2315663

Additional information

Funding

This work was supported by the Graduate Innovation and Entrepreneurship project, Central South University [grant number 2023ZZTS0909].