Exploring how older adults perceived the impact of infectious diseases and vaccines on ageing: a cross-sectional study in France

This cross-sectional study examined perceptions of health and ageing, and their influence on vaccine acceptance among individuals aged 65 and older living at home in the Auvergne-Rhône-Alpes region of France. Anonymous online questionnaires were distributed to users of CARSAT Rhône-Alpes (N1 = 50,000) and Auvergne (N2 = 9,597). The 62-question survey covered vaccination perceptions, the impact of the Covid-19 pandemic, health concerns, preventive measures, health information sources, and vaccination history. Vaccine hesitancy was assessed using the 5 C model, categorizing respondents into the group ‘Opposed’, ‘Hesitant’, and ‘Very Favourable’ to vaccination based on vaccination history and reasons for non-vaccination. Out of 3,331 respondents, 2,416 questionnaires were analysable. Most participants identified stroke (43.4%), cancer (20.4%), and dementia (18%) as primary health concerns. Infectious diseases ranked lowest, with pneumonia (1.24%), Covid-19 (0.89%), influenza (0.43%), and shingles (0.11%) infrequently cited. The Hesitant group more frequently questioned vaccination recommendations (82%) compared to the Very Favourable group (74%). Opposed participants significantly doubted vaccine efficacy and its role in healthy aging, differing from Hesitant and Very Favourable participants (p < 0.001). Perceptions of vulnerability to infection and beliefs about the seriousness of vaccine-preventable diseases significantly differed among groups (p < 0.001), with higher agreement in the Very Favourable group. Health-preservation behaviours, like regular medical check-ups and vaccination, were more common among the Very Favourable group, with no correlation found between diet, physical activity, and vaccination status. The worry of infectious diseases is low compared to fear of disability. Differences in perceptions of infection vulnerability and vaccine efficacy highlight the need for targeted communication to enhance vaccine acceptance.