Influenza Vaccine Uptake in the Elderly: Biopsychosocial Vulnerabilities and Effectiveness of a Community-Health...

This quasi-experimental study examined the biopsychosocial (BPS) vulnerabilities of non-vaccinated elderly individuals, evaluated the effectiveness of community health workers (CHWs) in improving influenza vaccine uptake, and assessed the impact of a CHW-administered community-based health intervention (CBHI) on health-related quality of life (HRQoL). Pre- and post-intervention data were collected from participants enrolled in the "Get Well, Live Well" (GWLW) program. As part of this CBHI, hospital-employed CHWs applied various interventions to improve influenza vaccine awareness, accessibility, and timely administration. The BPS risk screener and EQ5D-3L were used to assess the individuals' initial biopsychosocial vulnerabilities and pre/post-program HRQoL respectively through face-to-face and telephone interviews. Influenza vaccination rates were computed and data were analyzed utilizing Chi-square and non-parametric tests, along with logistic regression analysis (α = 0.05). The final sample (n = 229) had a mean age of 73.15 ± 5.6 years and comprised 68.1% women and 87.8% Chinese. Non-vaccinated individuals were found to be younger and exhibited significantly greater social health risk and poorer self-rated health than their vaccinated counterparts. Multivariate analysis revealed that age was the primary predictor of non-vaccination (OR = 0.94; 95% CI = 0.90-0.99). The CHW-administered GWLW program doubled influenza vaccination rates (30.1-60.7%) and significantly improved the summary index, self-rated health, and prevalence of no pain/discomfort among the elderly. CBHIs, administered by hospital-employed non-medical CHWs, proved effective in improving influenza vaccination rates and elevating HRQoL. Future influenza vaccination efforts should prioritize socio-interpersonal interventions for the younger elderly.