Influenza vaccine hesitancy in the elderly: Where do we stand?

Background: Seasonal flu can cause severe illnesses and death, especially in risk groups, such as elderly.

Objectives: To identify and analyze studies related to influenza vaccine hesitancy and to identify the most reported factors/variables that explain vaccine hesitancy, regarding elderly.

Methods: A narrative review was carried out. Keywords were defined per each screened database: PubMed, SciELO and DOAJ.

Inclusion criteria: studies identifying potential explanatory factors of influenza vaccine hesitancy in older adults (last ten years).

Exclusion criteria: abstracts, letters to editors, commentaries, reviews, pilot and papers not written in Spanish, English, Portuguese and Italian. Variables related to vaccine hesitancy were identified and collected until saturation of data. These variables were codified according to 5C Model of Vaccine Hesitancy. Quality was checked with the Scale for the Assessment of Narrative Review Articles.

Results: 43 papers were selected. Overall, a set of sociodemographic variables and variables related to the 5C Model (e.g., confidence, complacency, constraints, risk calculation or collective responsibility) were identified as potentially relevant to explain vaccine hesitancy in elderly. The quality of the present narrative was classified as acceptable.

Conclusion: The present work makes a valuable contribution to the understanding influenza vaccine hesitancy in older populations, with the proposal of practical recommendations supported by literature. However, its narrative approach and single-author design limit the depth of analysis and the generalization of findings.