Research Article
BibTex RIS Cite

COVID-19, influenza, and pneumococcal vaccination awareness and uptake in geriatric patients: a cross-sectional study

Year 2025, Volume: 8 Issue: 5, 926 - 933, 16.09.2025
https://doi.org/10.32322/jhsm.1767263

Abstract

Aims: Respiratory tract infections are leading causes of morbidity and mortality in the geriatric population. The COVID-19 pandemic has reinforced the critical importance of vaccination against preventable respiratory diseases in elderly individuals. This study aimed to assess awareness levels, vaccination rates, and factors influencing vaccine acceptance for COVID-19, influenza, and pneumococcal vaccines among individuals aged ≥65 years.
Methods: This cross-sectional study was conducted between January 08, 2025, and February 28, 2025, involving patients aged ≥65 years who presented to the hospital for any reason. Structured interviews assessed vaccination history and awareness levels. Unvaccinated participants received standardized educational information about vaccine benefits and risks, followed by assessment of vaccination willingness. Demographic characteristics, educational level, and reasons for vaccine hesitancy were recorded. Statistical analysis was performed using SPSS v30.0, with Chi-square tests for categorical variables and p<0.05 considered significant.
Results: Among 168 participants (mean age 71.9±6.3 years, 52.4% female), vaccination rates were 96.4% for COVID-19, 59.5% for influenza (past year), and 14.9% for pneumococcal vaccine (past five years). Primary reasons for non-vaccination included lack of risk group awareness for pneumococcal (62.0%) and influenza vaccines (39.4%), while perceived vaccine inefficacy dominated COVID-19 hesitancy (85.7%). However, the COVID-19 unvaccinated subgroup was very small (n=6), limiting the robustness of statistical analysis for this vaccine. Higher educational level significantly correlated with influenza (p=0.032) and pneumococcal vaccination (p=0.018). Post-education, willingness to be vaccinated increased substantially: influenza 64.1%, pneumococcal 74.2%, and COVID-19 100%. It should be noted that this study measured vaccination intention rather than actual vaccine uptake.
Conclusion: Significant disparities exist in vaccination awareness and uptake across different vaccines in the geriatric population. However, as a single-center study focusing only on hospital-attending elderly adults, the generalizability of findings may be limited. Targeted educational interventions demonstrate substantial potential for improving vaccine acceptance intention. These findings highlight the need for healthcare provider-led education programs and policy initiatives to address knowledge gaps and enhance preventive care in this high-risk population.

References

  • Weinberger B. Vaccines for the elderly: current use and future challenges. Immun Ageing. 2018;15:3. doi:10.1186/s12979-017-0107-2
  • World Health Organization. Pneumococcal vaccines: WHO position paper. Wkly Epidemiol Rec. 2022;97(8):73-95.
  • Thompson WW, Shay DK, Weintraub E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA. 2003;289(2):179-186. doi:10.1001/jama.289.2.179
  • Centers for Disease Control and Prevention. Vaccination recommendations for older adults. Updated 2021. Accessed April 20, 2025. https://www.cdc.gov/vaccines/adults/rec-vac/index.html
  • Verger P, Dubé E. Restoring confidence in vaccines in the COVID-19 era. Expert Rev Vaccines. 2020;19(11):991-993. doi:10.1080/14760584.2020. 1825945
  • Lazarus JV, Ratzan SC, Palayew A, et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med. 2021;27(2):225-228. doi: 10.1038/s41591-020-1124-9
  • World Health Organization. Immunization in the Context of COVID-19 Pandemic: Practical Considerations. World Health Organization; 2021.
  • Domnich A, Arata L, Amicizia D, Puig-Barberà J, Gasparini R, Panatto D. Effectiveness of MF59-adjuvanted seasonal influenza vaccine in the elderly: a systematic review and meta-analysis. Vaccine. 2017;35(4):513-520. doi:10.1016/j.vaccine.2016.12.011
  • Kwok KO, Li KK, Wei WI, Tang A, Wong SYS, Lee SS. Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: a survey. Int J Nurs Stud. 2021;114:103854. doi:10.1016/j.ijnurstu. 2020.103854
  • Loomba S, de Figueiredo A, Piatek SJ, de Graaf K, Larson HJ. Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA. Nat Hum Behav. 2021;5(3):337-348. doi:10.1038/s41562-021-01056-1
  • Forman R, Shah S, Jeurissen P, Jit M, Mossialos E. COVID-19 vaccine challenges: what have we learned so far and what remains to be done? Health Policy. 2021;125(5):553-567. doi:10.1016/j.healthpol.2021.03.013
  • Yaqub O, Castle-Clarke S, Sevdalis N, Chataway J. Attitudes to vaccination: a critical review. Soc Sci Med. 2014;112:1-11. doi:10.1016/j.socscimed.2014.04.018
  • Porcari DE, Palmer K, Spalletta G, Ciullo V, Banaj N. A survey for examining the effects of COVID-19 and infection control measures in older persons with mild cognitive impairment and dementia and their caregivers. Front Psychiatry. 2020;11:599851. doi:10.3389/fpsyt.2020. 599851
  • Ciblak MA; Influenza Platform Working Group. Influenza vaccination in Turkiye: prevalence of risk groups, current vaccination status, factors influencing vaccine uptake and steps taken to increase vaccination rate. Vaccine. 2013;31(3):518-523. doi:10.1016/j.vaccine.2012.11.022
  • Gazibara T, Kovacevic N, Kisic-Tepavcevic D, et al. Flu vaccination among older persons: study of knowledge and practices. J Health Popul Nutr. 2019;38(1):2. doi:10.1186/s41043-018-0159-8
  • Schaffer DeRoo S, Pudalov NJ, Fu LY. Planning for a COVID-19 vaccination program. JAMA. 2020;323(24):2458-2459. doi:10.1001/jama.2020.8711
  • Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. 2020;323(18): 1775-1776. doi:10.1001/jama.2020.4683
  • World Health Organization. Global Influenza Strategy 2019-2030. World Health Organization; 2019.
  • Bonten MJM, Huijts SM, Bolkenbaas M, et al. Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. N Engl J Med. 2015; 372(12):1114-1125. doi:10.1056/NEJMoa1408544
  • Dereli F, Uyanik G, Duman JGY, Kundakçi G, Yilmaz M. Determination of immunization status of individuals aged 65 and over: family health center example. İKÇÜSBFD. 2022;7(2):291-301.
  • Kobayashi M, Pilishvili T, Farrar JL, et al. Systematic review and meta-analysis of the efficacy and effectiveness of pneumococcal vaccines in adults. Pathogens. 2023;12(5):732. doi:10.3390/pathogens12050732
  • Jennings W, Stoker G, Bunting H, et al. Lack of trust, conspiracy beliefs, and social media use predict COVID-19 vaccine hesitancy. Vaccines (Basel). 2021;9(6):593. doi:10.3390/vaccines9060593
  • MacDonald NE; SAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: definition, scope and determinants. Vaccine. 2015;33(34): 4161-4164. doi:10.1016/j.vaccine.2015.04.036
  • Eilers R, Krabbe PFM, de Melker HE. Factors affecting the uptake of vaccination by the elderly in Western society. Prev Med. 2014;69:224-234. doi:10.1016/j.ypmed.2014.10.017
  • Nagata JM, Hernández-Ramos I, Kurup AS, Albrecht D, Vivas-Torrealba C, Franco-Paredes C. Social determinants of health and seasonal influenza vaccination in adults ≥65 years: a systematic review of qualitative and quantitative data. BMC Public Health. 2013;13:388. doi:10.1186/1471-2458-13-388
  • Okan O, Bollweg TM, Berens EM, Hurrelmann K, Bauer U, Schaeffer D. Coronavirus-related health literacy: a cross-sectional study in adults during the COVID-19 infodemic in Germany. Int J Environ Res Public Health. 2020;17(15):5503. doi:10.3390/ijerph17155503
  • Castro-Sánchez E, Chang PWS, Vila-Candel R, Escobedo AA, Holmes AH. Health literacy and infectious diseases: why does it matter? Int J Infect Dis. 2016;43:103-110. doi:10.1016/j.ijid.2015.12.019
  • Lorini C, Santomauro F, Donzellini M, et al. Health literacy and vaccination: a systematic review. Hum Vaccin Immunother. 2018;14(2): 478-488. doi:10.1080/21645515.2017.1392423
  • Kopsaftis Z, Wood-Baker R, Poole P. Influenza vaccine for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev. 2018;6(6):CD002733. doi:10.1002/14651858.CD002733.pub3
  • Schmid P, Rauber D, Betsch C, Lidolt G, Denker ML. Barriers of influenza vaccination intention and behavior-a systematic review of influenza vaccine hesitancy, 2005-2016. PLoS One. 2017;12(1):e0170550. doi:10.1371/journal.pone.0170550
  • Jarrett C, Wilson R, O’Leary M, Eckersberger E, Larson HJ; SAGE Working Group on Vaccine Hesitancy. Strategies for addressing vaccine hesitancy-a systematic review. Vaccine. 2015;33(34):4180-4190. doi:10. 1016/j.vaccine.2015.04.040

COVID-19, influenza ve pnömokok aşıları hakkında farkındalık ve aşılama oranları: geriatrik hastalarda kesitsel bir çalışma

Year 2025, Volume: 8 Issue: 5, 926 - 933, 16.09.2025
https://doi.org/10.32322/jhsm.1767263

Abstract

Amaç: Solunum yolu enfeksiyonları, geriatrik popülasyonda morbidite ve mortalitenin önde gelen nedenlerindendir. COVID-19 pandemisi, yaşlı bireylerde önlenebilir solunum yolu hastalıklarına karşı aşılama uygulamalarının kritik önemini pekiştirmiştir. Bu çalışmada, 65 yaş ve üzeri bireylerde COVID-19, influenza ve pnömokok aşılarına ilişkin farkındalık düzeyleri, aşılama oranları ve aşı kabulünü etkileyen faktörlerin değerlendirilmesi amaçlanmıştır.
Yöntemler: Bu kesitsel çalışma, 8 Ocak 2025 ile 28 Şubat 2025 tarihleri arasında herhangi bir nedenle hastaneye başvuran ≥65 yaş hastalarla yürütülmüştür. Yapılandırılmış görüşmelerle aşı öyküsü ve farkındalık düzeyleri değerlendirilmiştir. Aşısız katılımcılara aşıların yararları ve riskleri hakkında standartlaştırılmış eğitim bilgisi verilmiş, ardından aşılama istekliliği yeniden değerlendirilmiştir. Demografik özellikler, eğitim düzeyi ve aşı tereddütü nedenleri kaydedilmiştir. İstatistiksel analiz SPSS v30.0 programı ile yapılmış, kategorik değişkenler için ki-kare testi kullanılmış ve p<0,05 anlamlı kabul edilmiştir.
Bulgular: Çalışmaya alınan 168 katılımcının (ortalama yaş 71,9±6,3 yıl; %52,4 kadın) aşılama oranları COVID-19 için %96,4, influenza için (geçen yıl) %59,5 ve pnömokok aşısı için (son beş yılda) %14,9 idi. Aşılanmama nedenleri arasında pnömokok (%62,0) ve influenza (%39,4) aşılarında risk grubu farkındalığının olmaması öne çıkarken, COVID-19 aşısına yönelik tereddütte aşıların etkisiz olduğu algısı (%85,7) baskındı. Yüksek eğitim düzeyi influenza (p=0,032) ve pnömokok aşılanması (p=0,018) ile anlamlı düzeyde ilişkili bulundu. Eğitim sonrasında aşılama istekliliği belirgin şekilde arttı: influenza %64,1, pnömokok %74,2 ve COVID-19 %100.
Sonuçlar: Geriatrik popülasyonda farklı aşılar arasında farkındalık ve aşılama oranlarında önemli farklılıklar mevcuttur. Hedefe yönelik eğitim müdahaleleri, aşı kabulünü artırmada önemli potansiyele sahiptir. Bulgular, bilgi eksikliklerini gidermeye ve bu yüksek riskli grupta koruyucu sağlık hizmetlerini geliştirmeye yönelik sağlık çalışanı liderliğinde eğitim programları ve politika girişimlerinin gerekliliğini vurgulamaktadır.

References

  • Weinberger B. Vaccines for the elderly: current use and future challenges. Immun Ageing. 2018;15:3. doi:10.1186/s12979-017-0107-2
  • World Health Organization. Pneumococcal vaccines: WHO position paper. Wkly Epidemiol Rec. 2022;97(8):73-95.
  • Thompson WW, Shay DK, Weintraub E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA. 2003;289(2):179-186. doi:10.1001/jama.289.2.179
  • Centers for Disease Control and Prevention. Vaccination recommendations for older adults. Updated 2021. Accessed April 20, 2025. https://www.cdc.gov/vaccines/adults/rec-vac/index.html
  • Verger P, Dubé E. Restoring confidence in vaccines in the COVID-19 era. Expert Rev Vaccines. 2020;19(11):991-993. doi:10.1080/14760584.2020. 1825945
  • Lazarus JV, Ratzan SC, Palayew A, et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med. 2021;27(2):225-228. doi: 10.1038/s41591-020-1124-9
  • World Health Organization. Immunization in the Context of COVID-19 Pandemic: Practical Considerations. World Health Organization; 2021.
  • Domnich A, Arata L, Amicizia D, Puig-Barberà J, Gasparini R, Panatto D. Effectiveness of MF59-adjuvanted seasonal influenza vaccine in the elderly: a systematic review and meta-analysis. Vaccine. 2017;35(4):513-520. doi:10.1016/j.vaccine.2016.12.011
  • Kwok KO, Li KK, Wei WI, Tang A, Wong SYS, Lee SS. Influenza vaccine uptake, COVID-19 vaccination intention and vaccine hesitancy among nurses: a survey. Int J Nurs Stud. 2021;114:103854. doi:10.1016/j.ijnurstu. 2020.103854
  • Loomba S, de Figueiredo A, Piatek SJ, de Graaf K, Larson HJ. Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA. Nat Hum Behav. 2021;5(3):337-348. doi:10.1038/s41562-021-01056-1
  • Forman R, Shah S, Jeurissen P, Jit M, Mossialos E. COVID-19 vaccine challenges: what have we learned so far and what remains to be done? Health Policy. 2021;125(5):553-567. doi:10.1016/j.healthpol.2021.03.013
  • Yaqub O, Castle-Clarke S, Sevdalis N, Chataway J. Attitudes to vaccination: a critical review. Soc Sci Med. 2014;112:1-11. doi:10.1016/j.socscimed.2014.04.018
  • Porcari DE, Palmer K, Spalletta G, Ciullo V, Banaj N. A survey for examining the effects of COVID-19 and infection control measures in older persons with mild cognitive impairment and dementia and their caregivers. Front Psychiatry. 2020;11:599851. doi:10.3389/fpsyt.2020. 599851
  • Ciblak MA; Influenza Platform Working Group. Influenza vaccination in Turkiye: prevalence of risk groups, current vaccination status, factors influencing vaccine uptake and steps taken to increase vaccination rate. Vaccine. 2013;31(3):518-523. doi:10.1016/j.vaccine.2012.11.022
  • Gazibara T, Kovacevic N, Kisic-Tepavcevic D, et al. Flu vaccination among older persons: study of knowledge and practices. J Health Popul Nutr. 2019;38(1):2. doi:10.1186/s41043-018-0159-8
  • Schaffer DeRoo S, Pudalov NJ, Fu LY. Planning for a COVID-19 vaccination program. JAMA. 2020;323(24):2458-2459. doi:10.1001/jama.2020.8711
  • Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. 2020;323(18): 1775-1776. doi:10.1001/jama.2020.4683
  • World Health Organization. Global Influenza Strategy 2019-2030. World Health Organization; 2019.
  • Bonten MJM, Huijts SM, Bolkenbaas M, et al. Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. N Engl J Med. 2015; 372(12):1114-1125. doi:10.1056/NEJMoa1408544
  • Dereli F, Uyanik G, Duman JGY, Kundakçi G, Yilmaz M. Determination of immunization status of individuals aged 65 and over: family health center example. İKÇÜSBFD. 2022;7(2):291-301.
  • Kobayashi M, Pilishvili T, Farrar JL, et al. Systematic review and meta-analysis of the efficacy and effectiveness of pneumococcal vaccines in adults. Pathogens. 2023;12(5):732. doi:10.3390/pathogens12050732
  • Jennings W, Stoker G, Bunting H, et al. Lack of trust, conspiracy beliefs, and social media use predict COVID-19 vaccine hesitancy. Vaccines (Basel). 2021;9(6):593. doi:10.3390/vaccines9060593
  • MacDonald NE; SAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: definition, scope and determinants. Vaccine. 2015;33(34): 4161-4164. doi:10.1016/j.vaccine.2015.04.036
  • Eilers R, Krabbe PFM, de Melker HE. Factors affecting the uptake of vaccination by the elderly in Western society. Prev Med. 2014;69:224-234. doi:10.1016/j.ypmed.2014.10.017
  • Nagata JM, Hernández-Ramos I, Kurup AS, Albrecht D, Vivas-Torrealba C, Franco-Paredes C. Social determinants of health and seasonal influenza vaccination in adults ≥65 years: a systematic review of qualitative and quantitative data. BMC Public Health. 2013;13:388. doi:10.1186/1471-2458-13-388
  • Okan O, Bollweg TM, Berens EM, Hurrelmann K, Bauer U, Schaeffer D. Coronavirus-related health literacy: a cross-sectional study in adults during the COVID-19 infodemic in Germany. Int J Environ Res Public Health. 2020;17(15):5503. doi:10.3390/ijerph17155503
  • Castro-Sánchez E, Chang PWS, Vila-Candel R, Escobedo AA, Holmes AH. Health literacy and infectious diseases: why does it matter? Int J Infect Dis. 2016;43:103-110. doi:10.1016/j.ijid.2015.12.019
  • Lorini C, Santomauro F, Donzellini M, et al. Health literacy and vaccination: a systematic review. Hum Vaccin Immunother. 2018;14(2): 478-488. doi:10.1080/21645515.2017.1392423
  • Kopsaftis Z, Wood-Baker R, Poole P. Influenza vaccine for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev. 2018;6(6):CD002733. doi:10.1002/14651858.CD002733.pub3
  • Schmid P, Rauber D, Betsch C, Lidolt G, Denker ML. Barriers of influenza vaccination intention and behavior-a systematic review of influenza vaccine hesitancy, 2005-2016. PLoS One. 2017;12(1):e0170550. doi:10.1371/journal.pone.0170550
  • Jarrett C, Wilson R, O’Leary M, Eckersberger E, Larson HJ; SAGE Working Group on Vaccine Hesitancy. Strategies for addressing vaccine hesitancy-a systematic review. Vaccine. 2015;33(34):4180-4190. doi:10. 1016/j.vaccine.2015.04.040
There are 31 citations in total.

Details

Primary Language English
Subjects Clinical Microbiology
Journal Section Original Article
Authors

Enes Dalmanoğlu 0000-0003-4425-5649

Ferda Özdemir This is me 0009-0006-5066-8537

Hatice Engin This is me 0009-0004-0189-8710

Mustafa Tekkoyun This is me 0009-0000-0245-9374

Hilmi Berkay Aslan This is me 0009-0002-4062-5681

Öykü Torun This is me 0009-0000-8533-1033

Büşra Hacı This is me 0009-0000-4473-5189

Abdulkerem Alegöz This is me 0009-0007-4234-6383

Publication Date September 16, 2025
Submission Date August 19, 2025
Acceptance Date September 3, 2025
Published in Issue Year 2025 Volume: 8 Issue: 5

Cite

AMA Dalmanoğlu E, Özdemir F, Engin H, et al. COVID-19, influenza, and pneumococcal vaccination awareness and uptake in geriatric patients: a cross-sectional study. J Health Sci Med / JHSM. September 2025;8(5):926-933. doi:10.32322/jhsm.1767263

Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS].

The Directories (indexes) and Platforms we are included in are at the bottom of the page.

Note: Our journal is not WOS indexed and therefore is not classified as Q.

You can download Council of Higher Education (CoHG) [Yüksek Öğretim Kurumu (YÖK)] Criteria) decisions about predatory/questionable journals and the author's clarification text and journal charge policy from your browser. https://dergipark.org.tr/tr/journal/2316/file/4905/show







The indexes of the journal are ULAKBİM TR Dizin, Index Copernicus, ICI World of Journals, DOAJ, Directory of Research Journals Indexing (DRJI), General Impact Factor, ASOS Index, WorldCat (OCLC), MIAR, EuroPub, OpenAIRE, Türkiye Citation Index, Türk Medline Index, InfoBase Index, Scilit, etc.

       images?q=tbn:ANd9GcRB9r6zRLDl0Pz7om2DQkiTQXqDtuq64Eb1Qg&usqp=CAU

500px-WorldCat_logo.svg.png

atifdizini.png

logo_world_of_journals_no_margin.png

images?q=tbn%3AANd9GcTNpvUjQ4Ffc6uQBqMQrqYMR53c7bRqD9rohCINkko0Y1a_hPSn&usqp=CAU

doaj.png  

images?q=tbn:ANd9GcSpOQFsFv3RdX0lIQJC3SwkFIA-CceHin_ujli_JrqBy3A32A_Tx_oMoIZn96EcrpLwTQg&usqp=CAU

ici2.png

asos-index.png

drji.png





The platforms of the journal are Google Scholar, CrossRef (DOI), ResearchBib, Open Access, COPE, ICMJE, NCBI, ORCID, Creative Commons, etc.

COPE-logo-300x199.jpgimages?q=tbn:ANd9GcQR6_qdgvxMP9owgnYzJ1M6CS_XzR_d7orTjA&usqp=CAU

icmje_1_orig.png

cc.logo.large.png

ncbi.pngimages?q=tbn:ANd9GcRBcJw8ia8S9TI4Fun5vj3HPzEcEKIvF_jtnw&usqp=CAU

ORCID_logo.png

1*mvsP194Golg0Dmo2rjJ-oQ.jpeg


Our Journal using the DergiPark system indexed are;

Ulakbim TR Dizin,  Index Copernicus, ICI World of JournalsDirectory of Research Journals Indexing (DRJI), General Impact FactorASOS Index, OpenAIRE, MIAR,  EuroPub, WorldCat (OCLC)DOAJ,  Türkiye Citation Index, Türk Medline Index, InfoBase Index


Our Journal using the DergiPark system platforms are;

Google, Google Scholar, CrossRef (DOI), ResearchBib, ICJME, COPE, NCBI, ORCID, Creative Commons, Open Access, and etc.


Journal articles are evaluated as "Double-Blind Peer Review". 

Our journal has adopted the Open Access Policy and articles in JHSM are Open Access and fully comply with Open Access instructions. All articles in the system can be accessed and read without a journal user.  https//dergipark.org.tr/tr/pub/jhsm/page/9535

Journal charge policy   https://dergipark.org.tr/tr/pub/jhsm/page/10912

Our journal has been indexed in DOAJ as of May 18, 2020.

Our journal has been indexed in TR-Dizin as of March 12, 2021.


17873

Articles published in the Journal of Health Sciences and Medicine have open access and are licensed under the Creative Commons CC BY-NC-ND 4.0 International License.