What factors affect influenza vaccine uptake among community-dwelling older Chinese people in Hong Kong general outpatient clinics?

J Clin Nurs. 2009 Apr;18(7):960-71. doi: 10.1111/j.1365-2702.2008.02548.x. Epub 2009 Jan 8.


Aim: This study aimed to identify the influenza vaccination rate among community-dwelling older Chinese people in Hong Kong general outpatient clinics and to identify the factors affecting their vaccine uptake.

Background: Community-dwelling older Chinese people in Hong Kong underuse influenza vaccination. The first step to increase their vaccination rates is to understand the factors affecting their influenza vaccine uptake.

Design: This was a retrospective and descriptive study.

Methods: The sample comprised 197 subjects from five general outpatient clinics in the Kowloon East cluster of Hong Kong. A self-report questionnaire was used for data collection via individual face-to-face interviews.

Results: Out of 197 subjects, 64.47% reported having received the vaccine within the previous 12 months. The regression model revealed that perceived benefits including 'vaccination prevents me from catching influenza (OR = 12.18, CI = 3.61-41.07, p < 0.001)', 'If I get vaccinated, I will decrease the frequency of medical consultation (OR = 8.12, CI = 2.70-24.38, p = 0.001)' and 'If I am vaccinated and still get flu, I will not be as sick with it (OR = 0.43, CI = 0.24-0.76, p = 0.004)', perceived barriers, which are 'the side-effects of influenza vaccination interfere with my usual activities (OR = 0.04, CI = 0.01-0.13, p < 0.001)', 'influenza vaccination is painful (OR = 2.73, CI = 1.55-4.81, p = 0.001)' and 'I am scared of needles (OR = 0.43, CI = 0.23-0.79, p = 0.007)' and recommendations from doctors (OR = 14.18, CR = 4.09-49.16, p < 0.001) and families (OR = 3.67, CR = 1.24-10.83, p = 0.019) interactively influenced the subjects' vaccine uptake.

Conclusion: Specific benefits and barriers affecting the influenza uptake of community-dwelling older Chinese people in general outpatient clinics have been identified. Specifically, recommendation from families plays a significant role in motivating the uptake of this Chinese ageing group.

Relevance to clinical practice: We adopt strategies including personal invitation and reminders of influenza vaccination by doctors and educating doctors, older people and their families on influenza vaccination to increase the uptake of community-dwelling Chinese older people in general outpatient clinics.

MeSH terms

  • Aged* / psychology
  • Aged* / statistics & numerical data
  • Aged, 80 and over
  • Ambulatory Care Facilities / organization & administration
  • Cross-Sectional Studies
  • Female
  • Health Behavior / ethnology
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility
  • Hong Kong
  • Humans
  • Influenza Vaccines*
  • Logistic Models
  • Male
  • Models, Psychological
  • Motivation
  • Nursing Methodology Research
  • Patient Acceptance of Health Care* / ethnology
  • Patient Acceptance of Health Care* / statistics & numerical data
  • Retrospective Studies
  • Socioeconomic Factors
  • Statistics, Nonparametric
  • Surveys and Questionnaires
  • Vaccination* / psychology
  • Vaccination* / statistics & numerical data


  • Influenza Vaccines