Factors associated with willingness among adults to receive pneumococcal vaccine in Hong Kong: a cross-sectional...

Pneumococcal infections pose a significant global health risk, especially for elderly and immunocompromised populations. This study explores the willingness of Hong Kong adults aged 18-64 years with risk conditions of pneumococcal and aged 65 years or above to receive the pneumococcal vaccine and identifies the factors influencing this willingness.

A territory-wide cross-sectional survey was conducted between December 2024 and February 2025 among the Hong Kong adults aged 18-64 years with risk conditions of pneumococcal and aged 65 years or above. Convenience sampling was adopted and participant were recruited from online advertainments. Data were gathered on sociodemographic characteristics, Health Belief Model (HBM) constructs, vaccine knowledge, and trust in the healthcare system. Logistic regression analyses were used to identify factors associated with willingness to receive the pneumococcal vaccine.

A total of 1020 participants (580 males, 440 females; 39.9 % aged 50-64 years) participated in the study. Of these, 73.8 % (n = 753) expressed a willingness to receive the pneumococcal vaccine within the next 12 months. Participants self-reported as healthy were less likely to report willingness (AOR, 95 % CI 0.538 [0.322-0.898], p = 0.018), while participants with smoking (AOR, 95 % CI 2.184 [1.314-3.630], p = 0.003) and prior flu vaccination (AOR, 95 % CI 3.155 [2.040-4.878], p < 0.001) were more likely to report willingness. Higher acceptance of a single-dose vaccine also correlated with greater willingness (AOR, 95 % CI 3.582 [2.404-5.338], p < 0.001). In addition, participant with higher level of self-efficacy (AOR, 95 % CI 5.882 [3.369-10.269], p < 0.001), perceived susceptibility to pneumococcus (AOR, 95 % CI 2.079 [1.249-3.459], p = 0.005), perceived vaccine benefits (AOR, 95 % CI 3.920 [2.271-6.766], p < 0.001), and cues to action (AOR, 95 % CI 3.925 [2.400-6.417], p < 0.001) were more likely to report willingness.

This study identifies key factors influencing willingness to receive the pneumococcal vaccine, particularly those related to the HBM. Targeted public health interventions addressing these factors could increase vaccine uptake, improving protection for high-risk populations and enhancing public health outcomes. Further studies could employ longitudinal designs to track changes in vaccine intentions and evaluate the effectiveness of targeted interventions.