title: Factors affecting the uptake of vaccination by the elderly in Western society.
abstract: OBJECTIVE
  To present the results of a literature review on factors related to vaccine uptake by elderly persons.
  
  
  METHODS
  A systematic literature search was performed using Medline, Embase, and SciSearch to collect all publications available on factors related to vaccine uptake from 1966 until October 2012 for West European and North American societies. In total, 1001 articles were identified and 60 were included in the review.
  
  
  RESULTS
  We identified six main themes that influence the willingness to be vaccinated: 1) attitudes and beliefs regarding vaccination in general including positive and negative attitudes and beliefs; 2) perceived risk and severity including knowledge, perceived susceptibility and severity and personal experience; 3) vaccine characteristics including side-effects, effectiveness, content of the vaccine and knowledge; 4) advice and information including influence of the healthcare worker and relatives and the information source and format; 5) general health-related behavior including previous vaccinations, visiting GP or senior center and other preventive behaviors; and 6) accessibility and affordability including logistics, combinations of vaccines and costs.
  
  
  CONCLUSIONS
  The most important factors related to vaccine uptake are people's attitudes and beliefs regarding vaccination (especially their negative attitudes), recommendations of healthcare workers, side effects and effectiveness of the vaccine, and perceived susceptibility.
authors.affiliation: University of Groningen, Academic Medical Center Groningen, Department of Epidemiology, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: renske.eilers@rivm.nl.
authors.forename: R
authors.initials: R
authors.lastname: Eilers
authors.affiliation: University of Groningen, Academic Medical Center Groningen, Department of Epidemiology, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
authors.forename: P F M
authors.initials: PF
authors.lastname: Krabbe
authors.affiliation: Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
authors.forename: H E
authors.initials: HE
authors.lastname: de Melker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003140:Communicable Disease Control / Q000379:methods; D005060:Europe; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006297:Health Services Accessibility; D006801:Humans; D008875:Middle Aged; D009656:North America; D011369:Professional-Patient Relations; D012307:Risk Factors; D014611:Vaccination / Q000009:adverse effects / Q000191:economics / Q000523:psychology*
keywords: Elderly; Vaccination uptake; Western society