Understanding the drivers and barriers of elderly vaccination in post-pandemic China: a qualitative study in Shenzhen

Vaccination coverage among older adults in China remains suboptimal despite increased awareness of vaccination during the COVID-19 pandemic. This study aimed to investigate the key drivers and barriers to elderly vaccination in China. A qualitative study was conducted using the Critical Medical Anthropology (CMA) and the Integrative Model of Behavioral Prediction (IMBP) frameworks. Data were collected through in-depth interviews with 22 elderly individuals and 8 healthcare providers (HCPs) in Shenzhen between January and April 2024. Thematic analysis was employed to explore the significant factors influencing elderly vaccination across multiple levels. The study identified individual perceptions of vulnerability and vaccination benefits as key motivators for uptake. Family influence, peer interactions, and trust in HCPs served as critical social norms shaping vaccination decisions. Challenges such as COVID-19 vaccine fatigue, limited community engagement beyond COVID-19 vaccination efforts, policy disparities in free vaccine eligibility, and misinformation on social media were significant barriers. While the pandemic heightened public awareness of life-course immunization, it also triggered new vaccine hesitancy among older adults. The study highlights the need for targeted public health strategies, including policy adjustments to address free vaccination disparities, better involvement of family doctors, and enhanced communication to combat new emerging vaccine hesitancy. Promoting comprehensive life-course immunization is crucial for protecting China’s aging population in the post-pandemic era.