ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Self-perceptions of aging mediate illness perception and influenza vaccine hesitancy in elderly pneumonia patients during the 2024-2025 influenza season
Provisionally accepted
- 1Shaoxing University, Shaoxing, China
- 2Shaoxing Second Hospital, Shaoxing, China
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Background: As population aging accelerates, pneumonia cases in older adults continue to rise. Although vaccination effectively prevents influenza and reduces secondary pneumonia risk, hesitancy persists in this demographic. Previous studies have explored the link between illness perception and vaccine hesitancy, but the role of self-perceptions of aging in their relationship remains unclear. Methods: A cross-sectional study was conducted. From November 2024 to March 2025, 321 elderly pneumonia inpatients were recruited from a hospital in China. Data on illness perception, self-perceptions of aging, and influenza vaccine hesitancy were collected using the Brief Illness Perception Questionnaire, the brief version of the Attitudes to Aging Questionnaire, and the Influenza Vaccine Hesitancy Scale for individuals aged 60 years and above. Bootstrap sampling (replicates 5000) was used to examine the mediating role of self-perceptions of aging. Results: Among participants, 74.1% were unvaccinated. Illness perception positively correlated with influenza vaccine hesitancy (rs = 0.64, P < 0.01), while self-perceptions of aging negatively correlated with both (rs = -0.53, -0.75, P < 0.01). After controlling for covariates, an indirect association through self-perceptions of aging was observed in the relationship between illness perception and influenza vaccine hesitancy, accounting for 35.36% (95% CI: 22.56% - 51.39%) of the total association. Conclusion: This study highlights the importance of self-perceptions of aging toward vaccine take-up among elderly pneumonia patients. Interventions targeting attitudes toward aging may represent new strategies for increasing influenza vaccination rates.
Keywords: Influenza vaccine hesitancy, Self-perceptions of aging, illness perception, Pneumonia, Mediation analysis
Received: 12 Jul 2025; Accepted: 30 Oct 2025.
Copyright: © 2025 Liu, Wang, Zhu, Li, Wang and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shuiqin Xu, xsq@usx.edu.cn
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