Determinants of influenza vaccine preferences among community-dwelling older adults residents: a discrete choice experiment in Shihezi, China

Influenza vaccination among the older adults can effectively prevent influenza infection and reduce the outbreak of influenza and influenza-like diseases. This study examined the preferences and heterogeneity of preferences among community-dwelling older adults for influenza vaccines and key attributes of the vaccination process. We aimed to inform the development of demand-driven influenza vaccination strategies. Using a multi-stage cluster sampling approach, 654 older residents of Shihezi City, China, were surveyed. Preferences for influenza vaccination attributes were assessed with a mixed logit model to estimate relative attribute importance, willingness to pay, and heterogeneity across sociodemographic and health-related characteristics. Respondents consistently favored vaccines characterized by a lower incidence of adverse events, high protection rates, and lower out-of-pocket costs. Acceptance was greater when perceived disease severity was high and when vaccination was delivered within the community. The relative importance of vaccine attributes was as follows: incidence of non-serious adverse events (32.38%), protection rate (32.28%), vaccination site (18.54%), disease severity (11.75%), and incidence of serious adverse events (5.06%). Participants were willing to pay and additional 176.50 yuan and 391.00 yuan to reduce the incidence of non-serious adverse events from 50% to 20% and 10%, respectively. Substantial preference heterogeneity was observed by sex, marital status, education attainment, and self-rated health status. Vaccine safety and effectiveness are pivotal detriments of influenza vaccination decisions among community-dwelling older adults. Tailoring vaccination strategies to reflect these preferences, and to account for subgroup differences, may improve influenza vaccination rates in this population.