This rapid review aimed to present a comprehensive overview of barriers, facilitators, and effective interventions that promote vaccination uptake by older adults in the Asia-Pacific region. Rapid review methodology was applied, using two databases (PubMed, Embase). Articles were included if studies were conducted in Australia, Singapore, Indonesia, and the Philippines; included human population ≥50 years of age, and was published from 2016 to August 2022. Related articles were not found from Indonesia and Philippines. A total of 23 articles met the inclusion criteria, with 19 reporting on barriers and facilitators, whereas, four articles reported effective interventions to promote vaccination uptake. Among the 19 studies that identified barriers and facilitators to vaccination uptake, the more common factors were social influences (n = 8/19), perceived benefits of vaccine (n = 7/19), and perceived vaccine safety (n = 6/19). Interventions that focused on supporting clinicians were found to be effective in leading them to recommend vaccinations among older adults, such as creating awareness on the low baseline vaccination rates among older adults, provision of structured health assessment, and nurse reminders. More studies are needed to ascertain the barriers and facilitators to uptake, as well as to identify effective interventions influencing vaccine uptake among older adults in the Asia-Pacific region.
Department of Economic and Social Affairs, United Nations. Population division. World population prospects: the 2022 revision. Accessed April 7, 2024. https://population.un.org/wpp/
BhanuCGopalDPWaltersKChaudhryUAR. Vaccination uptake amongst older adults from minority ethnic backgrounds: a systematic review. PLoS Med. 2021;18(11):e1003826.
6.
KanTZhangJ.Factors influencing seasonal influenza vaccination behaviour among elderly people: a systematic review. Public Health. 2018;156:67-78.
7.
NguyenMHLi ChenLLimKWChangWTMamunK.Vaccination in older adults in Singapore: a summary of recent literature. Proc Singap Healthc. 2015;24(2):94-102.
8.
UsamiTHashiguchiMKouharaTIshiiANagataTMochizukiM.Impact of community pharmacists advocating immunization on influenza vaccination rates among the elderly. Yakugaku Zasshi. 2009;129(9):1063-1068.
9.
WangJFordLJWingateL, et al. Effect of pharmacist intervention on herpes zoster vaccination in community pharmacies. J Am Pharm Assoc. 2013;53(1):46-53.
10.
BanachDBOrnsteinKFactorSHSorianoTA.Seasonal influenza vaccination among homebound elderly receiving home-based primary care in New York City. J Community Health. 2012;37(1):10-14.
11.
ZimmermanRKBrownAEPavlikVN, et al. Using the 4 pillars practice transformation program to increase pneumococcal immunizations for older adults: a cluster-randomized trial. J Am Geriatr Soc. 2017;65(1):114-122.
12.
LooTSDavisRBLipsitzLA, et al. Electronic medical record reminders and panel management to improve primary care of elderly patients. Arch Intern Med. 2011;171(17):1552-1558.
13.
Vila-CórcolesAOchoa-GondarOEsterF, et al. Evolution of vaccination rates after the implementation of a free systematic pneumococcal vaccination in Catalonian older adults: 4-years follow-up. BMC Public Health. 2006;6(1):231.
14.
EidenALBarrattJNyakuMK.A review of factors influencing vaccination policies and programs for older adults globally. Hum Vaccin Immunother. 2023;19(1):2157164.
EilersRKrabbePFde MelkerHE.Factors affecting the uptake of vaccination by the elderly in Western society. Prev Med. 2014;69:224-234.
23.
TeoLMSmithHELwinMOTangWE.Attitudes and perception of influenza vaccines among older people in Singapore: a qualitative study. Vaccine. 2019;37(44):6665-6672.
24.
WaltzTJPowellBJMatthieuMM, et al. Use of concept mapping to characterize relationships among implementation strategies and assess their feasibility and importance: results from the Expert Recommendations for Implementing Change (ERIC) study. Implementation Science. 2015;10(1):109.
25.
TriccoACLillieEZarinW, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467-473.
26.
EnticottJGillJSBaconSL, et al. Attitudes towards vaccines and intention to vaccinate against COVID—19: a cross—sectional analysis—implications for public health communications in Australia. BMJ Open. 2022;12(1):e057127.
27.
TrentMJSalmonDAMacIntyreCR.Predictors of pneumococcal vaccination among Australian adults at high risk of pneumococcal disease. Vaccine. 2022;40(8):1152-1161.
28.
BriggsLFronekPQuinnVWildeT.Perceptions of influenza and pneumococcal vaccine uptake by older persons in Australia. Vaccine. 2019;37(32):4454-4459.
29.
LuptonD.Understandings and practices related to risk, immunity and vaccination during the Delta variant COVID-19 outbreak in Australia: an interview study. Vaccine: X. 2022;11:100183.
30.
AngLWCutterJJamesLGohKT.Factors associated with influenza vaccine uptake in older adults living in the community in Singapore. Epidemiol Infect. 2017;145(4):775-786.
31.
FrankODe Oliveira BernardoCGonzález-ChicaDAMacartneyKMenziesRStocksN.Pneumococcal vaccination uptake among patients aged 65 years or over in Australian general practice. Hum Vaccin Immunother. 2020;16(4):965-971.
32.
LinJWoodJGBernardoCStocksNPLiuB.Herpes zoster vaccine coverage in Australia before and after introduction of a national vaccination program. Vaccine. 2020;38(20):3646-3652.
33.
TanMStraughanPTCheongG.Information trust and COVID-19 vaccine hesitancy amongst middle-aged and older adults in Singapore: a latent class analysis approach. Soc Sci Med. 2022;296:114767.
34.
KaufmanJBagotKLTuckermanJ, et al. Qualitative exploration of intentions, concerns and information needs of vaccine-hesitant adults initially prioritised to receive COVID-19 vaccines in Australia. Aust N Z J Public Health. 2022;46(1): 16-24.
35.
CummingsCLKongWYOrminskiJ.A typology of beliefs and misperceptions about the influenza disease and vaccine among older adults in Singapore. PLoS ONE. 2020;15(5):e0232472.
36.
HoHJChanYYIbrahimMABWagleAAWongCMChowA.A formative research-guided educational intervention to improve the knowledge and attitudes of seniors towards influenza and pneumococcal vaccinations. Vaccine. 2017;35(47):6367-6374.
37.
AngLWCutterJJamesLGohKT.Epidemiological characteristics associated with uptake of pneumococcal vaccine among older adults living in the community in Singapore: results from the National Health Surveillance Survey 2013. Scand J Public Health. 2018;46(2):175-181.
38.
GrahamSBlaxlandMBoltR, et al. Aboriginal peoples’ perspectives about COVID-19 vaccines and motivations to seek vaccination: a qualitative study. BMJ Glob Health. 2022;7(7):e008815.
39.
HamiltonEMOversbySRatschAKitchenerS.COVID-19 vaccination: an exploratory study of the motivations and concerns detailed in the medical records of a regional Australian population. Vaccines. 2022;10(5):657.
40.
HoHJTanYRCookAR, et al. Increasing influenza and pneumococcal vaccination uptake in seniors using point-of-care informational interventions in primary care in Singapore: a pragmatic, cluster-randomized crossover trial. Am J Public Health. 2019;109(12):1776-1783.
41.
BaylissJRandhawaROhKB, et al. Perceptions of vaccine preventable diseases in Australian healthcare: focus on pertussis. Hum Vaccin Immunother. 2021;17(2):344-350.
42.
BurkePFMastersDMasseyG.Enablers and barriers to COVID-19 vaccine uptake: an international study of perceptions and intentions. Vaccine. 2021;39(36):5116-5128.
43.
WardleJFrawleyJAdamsJSibbrittDSteelALaucheR.Associations between complementary medicine utilization and influenza/pneumococcal vaccination: results of a national cross-sectional survey of 9151 Australian women. Prev Med. 2017;105:184-189.
44.
LiAChanYHLiewMFPandeyRPhuaJ.Improving influenza vaccination coverage among patients with COPD: a pilot project. Int J Chron Obstruct Pulmon Dis. 2019;14:2527-2533.
45.
LinJDobbinsTWoodJGHallJJLiuB.Impact of a structured older persons health assessment on herpes zoster vaccine uptake in Australian primary care. Prev Med. 2022;155:106946.
46.
YueMWangYLowCKYoongJSCookAR.Optimal design of population-level financial incentives of influenza vaccination for the elderly. Value Health. 2020;23(2):200-208.
47.
JainAvan HoekAJBocciaDThomasSL.Lower vaccine uptake amongst older individuals living alone: a systematic review and meta-analysis of social determinants of vaccine uptake. Vaccine. 2017;35(18):2315-2328.
48.
Department of Health and Aged, Australian Government. Immunisation for Adults and SENIORS. Department of Health and Aged Care, Australian Government; 2017.
49.
BeardFHendryAMacartneyK.Influenza vaccination uptake in our most vulnerable groups: how well are we protecting them in 2019?Commun Dis Intell. 2018;44.
Abu-RishEYBarakatNA.The impact of pharmacist-led educational intervention on pneumococcal vaccine awareness and acceptance among elderly in Jordan. Hum Vaccin Immunother. 2021;17(4):1181-1189.
54.
PizziLTPrioliKMFields HarrisL, et al. Knowledge, activation, and costs of the pharmacists’ pneumonia prevention program (PPPP): a novel senior center model to promote vaccination. Ann Pharmacother. 2018;52(5):446-453.
55.
DuttaOLallPPatinadanPV, et al. Patient autonomy and participation in end-of-life decision-making: an interpretive-systemic focus group study on perspectives of Asian healthcare professionals. Palliat Support Care. 2020;18(4): 425-430.
56.
KamimuraATrinhHNWeaverS, et al. Knowledge and beliefs about HPV among college students in Vietnam and the United States. J Infect Public Health. 2018;11(1):120-125.
57.
MageeLKnightsFMcKechnieDGJAl-BedaeryRRazaiMS.Facilitators and barriers to COVID-19 vaccination uptake among ethnic minorities: a qualitative study in primary care. PLoS ONE. 2022;17(7):e0270504.
58.
SrivastavABlackCLLutzCS, et al. U.S. clinicians’ and pharmacists’ reported barriers to implementation of the Standards for Adult Immunization Practice. Vaccine. 2018;36(45):6772-6781.
59.
BachATKangAYLewisJXavioerSPortilloIGoadJA.Addressing common barriers in adult immunizations: a review of interventions. Expert Rev Vaccines. 2019;18(11):1167-1185.
60.
SheikhAIqbalBEhtamamA, et al. Reasons for non-vaccination in pediatric patients visiting tertiary care centers in a polio-prone country. Arch Public Health. 2013;71(1):19.
61.
MaloneJDadswellA.The role of religion, spirituality and/or belief in positive ageing for older adults. Geriatrics (Basel). 2018;3(2):28.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
