Vaccination experiences and decision-making in older adult Korean immigrants living in Canada: A qualitative descriptive study

Older adult immigrants face unique challenges in accessing healthcare and preventive health measures, including vaccines. While Asian immigrants in North America generally report high vaccine uptake, studies suggest that Korean immigrants may have lower willingness to vaccinate and experience barriers to healthcare utilization. Understanding the vaccination experiences and decision-making processes of this population is critical to addressing disparities in and improving vaccine uptake. Therefore, we conducted a qualitative descriptive study to explore the influenza, pneumococcal, and shingles vaccination experiences, perceptions, and decision-making among older adult Korean immigrants in Canada. Study participants were recruited using convenience, snowball, and purposeful sampling. Semi-structured interviews were conducted with 30 Korean immigrants aged 65 years and older residing in Montreal and Toronto, Canada from September 2023 to July 2024. Interview transcripts and field notes were thematically analyzed, guided by the socio-ecological model. Key themes across intrapersonal-, interpersonal-, institutional-, community-, and policy-levels were identified. Participants reported strong willingness to get vaccinated, largely influenced by healthcare provider recommendations, government guidance, and perceived disease risk. However, gaps in vaccine knowledge, concerns about vaccine safety, and lack of explicit healthcare provider recommendations contributed to non-vaccination. Participants identified trust in the Canadian government and medical professionals as primary motivators to adhere to vaccination guidelines. Some vaccination-specific facilitators and/or barriers were also identified (e.g., financial barriers to shingles vaccination). Strategies to improve vaccine uptake among older adult Korean immigrants could involve supporting healthcare providers or public health efforts to promote vaccinations, encouraging healthcare providers to address concerns and emphasize safety and benefits of vaccinations using shared decision making, and collaborating with faith-based communities to promote vaccinations.