title: Factors associated with pneumococcal vaccination among an urban elderly population in China.
abstract: OBJECTIVE
  To investigate the coverage of the 23-valent pneumococcal polysaccharide vaccine (23-PPV) in the Chinese urban elderly population and to understand the attitudes, knowledge and beliefs of this population toward the 23-PPV vaccination.
  
  
  METHODS
  A cross-sectional approach was employed to survey the willingness of this population to receive the 23-PPV vaccination. Two thousand 9 hundred 2 six subjects over the age of 60 y were enrolled via a multi-stage random sampling method from the urban community population in Hangzhou, China. The relationships between the variables and the willingness to receive the 23-PPV vaccination were computed as odds ratios (ORs) by multivariate analysis.
  
  
  RESULTS
  Of the participants, 21.77% were willing to undergo 23-PPV vaccination, and 61.65% of the subjects agreed that pneumonia is a serious disease among elderly people. The rate of reasonable perceptions about vaccination, including the perception about vaccine efficacy and safety, among the subjects was below 50%. Only 1.23% of subjects had been vaccinated with 23-PPV, and a similarly low rate was observed for the seasonal influenza vaccine (4.17%). The factors that were independently related to the willingness to receive the 23-PPV vaccine included consensus with the hazards of pneumonia (OR = 1.67, 95% CI: 1.28 - 2.17), the safety of vaccination (OR = 2.00, 95% CI: 1.54 - 2.59), advice about the 23-PPV vaccination from family members (OR = 2.37, 95% CI: 1.39 - 4.40), influenza vaccination history (OR = 2.57, 95% CI: 1.66 - 3.98) and pneumococcal vaccination history (OR = 7.48, 95% CI: 2.4-22.92).
  
  
  CONCLUSIONS
  The administration of the 23-PPV vaccine among the urban elderly population is not optimistic in China. Emphasis on persuasion from families and the improvement of knowledge about vaccination might encourage elderly people to get the 23-PPV vaccination. Suggestions from physicians did not affect the participants' willingness to get the 23-PPV vaccination in multivariate analysis, but elderly people typically visited the Community Health Center (CHC) in their residential districts, and thus, systematic encouragement from healthcare physicians might be the key to increasing 23-PPV vaccination.
authors.affiliation: a Hangzhou Center for Disease Control and Prevention ; Hangzhou , China.
authors.forename: Shijun
authors.initials: S
authors.lastname: Liu
authors.forename: Erping
authors.initials: E
authors.lastname: Xu
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.forename: Yuyang
authors.initials: Y
authors.lastname: Xu
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.forename: Jian
authors.initials: J
authors.lastname: Du
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Zhang
authors.forename: Xinren
authors.initials: X
authors.lastname: Che
authors.forename: Wenwen
authors.initials: W
authors.lastname: Gu
mesh_terms: D000368:Aged; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D011018:Pneumonia, Pneumococcal / Q000276:immunology / Q000517:prevention & control; D013296:Streptococcus pneumoniae / Q000276:immunology; D011795:Surveys and Questionnaires; D014505:Urban Population; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data*
chemical_list: C414006:23-valent pneumococcal capsular polysaccharide vaccine; D022242:Pneumococcal Vaccines
keywords: 23-PPV, 23-valent pneumococcal polysaccharide vaccine; 23-valent pneumococcal polysaccharide vaccine; CHC, community health center; CI, confidence interval; HR, health record; IPD, invasive pneumococcal disease; OR, odds ratios; cross-sectional study; elderly population; immunization; pneumococcal vaccination