LAUSR

ABSTRACT Background In the context of China’s rapidly aging population and persistently low pneumococcal vaccine coverage, this study applied the Behavioral and Social Drivers (BeSD) framework to investigate the willingness and determinants of pneumococcal vaccination among adults aged 60 years and older in Chongqing. Research design and methods We designed a cross-sectional survey targeting the community population and collected data on willingness toward pneumonia vaccination and associated demographic factors through questionnaires. Results A total of 1,617 valid questionnaires were collected, 37.7% expressed willingness to receive pneumococcal vaccines. Higher vaccination willingness was associated with living in urban areas, having urban employee basic medical insurance, having an average monthly household income per capita below 2,000 CNY, being aware of pneumococcal vaccines, and showing interest in receiving vaccination information. Concerning the BeSD framework, concern over worsening health condition emerged as the primary driver, whereas perceived high vaccine costs and lack of awareness about vaccine were identified as major reasons for hesitancy. Conclusions This study provides that future strategies should focus on addressing psychological determinants within old adults, alongside extensive promotion of knowledge regarding pneumonia vaccination, as well as exploring the impact of financial incentives on vaccination programs and payment strategies to enhance vaccination coverage.