Changes in 23-valent pneumococcal polysaccharide vaccination rate and associated factors in 2022 and 2024 among community-based older adults in Shanghai, China

Pneumococcal vaccination effectively reduces the incidence of pneumococcal pneumonia and the associated mortality rates in older adults. Understanding trends in coverage and the influencing factors is essential for optimizing future vaccination programs. Two cross-sectional surveys were conducted in October 2022 and September 2024 among residents aged 60 and above in Pudong New Area, Shanghai. Data on demographic characteristics, pneumococcal vaccination status, and reasons for either receiving or not receiving the vaccine were also collected. A generalized linear mixed model (GLMM) investigated temporal trends in vaccination rates, adjusting for sociodemographic factors. Interactions with the survey year were evaluated to identify associated with time-varying effects on vaccination. The pneumococcal vaccination rate was 34.8% (95% confidence interval [CI]: 32.9-36.6) in 2024, a significant increase of 10.6% points from 24.1% (95% CI: 22.4-25.8) in 2022. (<i>P</i> < .01). Living alone and residence in a care facility were consistently associated with lower vaccination uptake. The proportion of people worried about adverse vaccine reactions increased compared to that in 2022. Although the pneumococcal vaccination coverage in Pudong New Area, Shanghai, has improved in recent years, it remains substantially lower than the rates observed in other developed countries and regions. Targeted monitoring and intervention programs need to be prioritized for vulnerable groups such as those living alone and in older adult care facilities.