Background: Previous studies investigated the determinants of individuals' decision to vaccinate against influenza primarily focusing on social as well as certain proximal determinants, for example, behavioral beliefs. Thus, so far, the analysis of psychological factors as determinants of influenza vaccination was mainly limited to beliefs, attitudes or perceptions that were directly related to influenza vaccination and its perceived impact. However, considering general psychological factors, like general self-efficacy, optimism or subjective well-being, might further enhance the understanding of why certain people vaccinate while others do not. The aim was to investigate the relationship between various general psychological factors and older people's decision to vaccinate against seasonal flu.
Methods: The data of individuals aged 60 or older (n = 5037; in 2014) were used from the Germany Ageing Survey. The data were collected in face-to-face interviews and in self-administered questionnaires. They include questions on the use of influenza vaccination and the psychological factors of optimism, self-efficacy, self-esteem, perceived stress, self-regulation, life satisfaction, and negative affect as well as positive affect. The psychological determinants of regular influenza vaccination were investigated using multiple logistic regressions.
Results: 53.2% of all participants were regular users of influenza vaccination. There were significant bivariate correlations of all cited psychological factor with influenza vaccination except for life satisfaction and negative affect. After controlling for numerous potential socio-demographic, morbidity- and lifestyle-related confounders, regular influenza vaccination was still positively associated with lower levels of self-esteem and a higher level of perceived stress.
Conclusions: There are significant associations of general individual psychological constructs with the decision to vaccinate against influenza. Future research might determine the impact of psychological factors on the decision to vaccinate in longitudinal research designs. This might be helpful to understand the causal mechanisms behind this relationship, which could help to design interventions that increase vaccination rates in certain target groups.
Keywords: Influenza vaccination; Perceived stress; Psychology; Self-esteem.