Determinants of Influenza, Pneumococcal and Varicella-Zoster Vaccine Hesitancy in Older Adults Attending a Geriatric Clinic in Nigeria

Abstract

BACKGROUND Influenza, pneumococcal disease, and shingles are vaccine-preventable diseases with high morbidity and mortality in older adults. Nigeria lacks a national immunisation program for older adults as well as empirical evidence on the uptake and hesitancy to the vaccines for these diseases. This study determined the level and factors associated with the uptake and hesitancy to influenza, pneumococcal, and varicella zoster vaccines among older adults at the Geriatric Centre, University College Hospital, Ibadan, Nigeria. METHODOLOGY This was a cross-sectional hospital-based study of older adults (≥60 years). Data were obtained from 332 patients in the outpatient clinic of the Chief Tony Anenih Geriatric Centre (CTAGC) of the University College Hospital (UCH), Ibadan, Nigeria. Participants were selected using a systematic sampling method, collecting data from January to March of 2023. Univariate and multivariate analyses were carried out at 5% significance. RESULTS Out of the 332 participants recruited, mean age was 71.8±7.3 years and female-to-male ratio 1.24. Vaccination rates were low for influenza (2.7%), pneumococcal (2.4%), and varicella zoster (0.9%). Vaccine hesitancy rates were 79.2% (influenza), 78.6% (pneumococcal), and 81.6% (varicella zoster). Bivariate analysis revealed significant associations with vaccine hesitancy, including low education, low income, living with family, financial and social support, concerns over side effects, commercial profiteering, reliance on natural immunity, risk calculation, collective responsibility, and negative perceptions of vaccine safety and effectiveness. Multivariate logistic regression identified a preference for natural immunity, greater calculation of disease and vaccination risk, and vaccine safety concerns as predictors of hesitancy to influenza, pneumococcal, and varicella zoster vaccines. CONCLUSION AND RECOMMENDATIONS The uptake of influenza, pneumococcal, and varicella zoster vaccines was poor among older adults in our setting,while vaccine hesitancy was high indicating that a high proportion of older adults were unwilling and undecided to take the vaccines. Investigating and addressing vaccination concerns such as preference for natural immunity, greater calculation of disease and vaccination risk, and concerns about vaccine safety may improve vaccination coverage among older adults.