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Peer-reviewedCC BYJAMA network open

Influenza Vaccination Preferences Among Adults Aged 60 Years and Older in Beijing, China

5 affiliations
  1. 1Key Laboratory of Pathogen Infection Prevention and Control (Peking Union Medical College), Ministry of Education, National Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  2. 2School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, State Key Laboratory of Respiratory Health and Multimorbidity, Public Health Emergency Management Innovation Center of Beijing Higher Education Innovation Center for Philosophy and Social Sciences, Beijing, China
  3. 3Beijing Dongcheng Center for Disease Control and Prevention, Beijing, China
  4. 4Beijing Changping District Center for Disease Control and Prevention (Changping District Health Supervision Institute), Beijing, China
  5. 5Yanjing Medical College, Capital Medical University, Beijing, China

Abstract

Importance: Influenza vaccination coverage among older adults remains suboptimal in China despite free vaccination policies in some regions. Understanding their preferences may inform strategies to improve uptake.

Objective: To quantify preferences for influenza vaccination attributes and assess preference heterogeneity by prior influenza vaccination history.

Design, Setting, and Participants: This community-based survey study was conducted at 2 districts in Beijing, China, where influenza vaccination is provided free of charge for adults aged 60 years or older. A convenience sample of adults aged 60 years or older was included from 6 Beijing subdistricts and participated in a discrete choice experiment conducted from August to September 2025.

Main Outcomes and Measures: Stated choice among 2 hypothetical influenza vaccination profiles and an opt-out option. Attributes included vaccine effectiveness, risk of mild adverse effects, vaccination venue and operating hours, outreach method, information source, and message content. Conditional logit, mixed logit, scenario simulations, and vaccination-history interaction analyses were performed.

Results: Among 514 participants included in the analyses, the median age was 71 years (IQR, 65-79 years), and 356 (69.3%) were women. Higher vaccine effectiveness was associated with greater vaccination preference (β = 2.12; 95% CI, 1.37 to 2.88), whereas higher perceived risk of mild adverse effects was associated with lower preference (β = −5.53; 95% CI, −7.83 to −3.22). Participants preferred community-based vaccination settings, telephone reminders (β = 1.06; 95% CI, 0.76 to 1.36), information from government or community organizations (β = 0.78; 95% CI, 0.54 to 1.02), and messages emphasizing protection of family members (β = 0.50; 95% CI, 0.26 to 0.74). Increasing vaccine effectiveness from 20% to 80% and reducing perceived risk of adverse effects from 20% to 5% were associated with 30.74– and 19.96–percentage-point (pp) increases in the model-estimated choice probability, respectively. Compared with participants with prior vaccination, never-vaccinated participants had a greater preference for opting out (difference in β = 1.07; 95% CI, 0.11 to 2.03), greater sensitivity to mild adverse effect risk (difference in β per 10-pp increase, −0.49; 95% CI, −0.93 to −0.05), and lower responsiveness to vaccine effectiveness (difference in β per 10-pp increase, −0.18; 95% CI, −0.31 to −0.04).

Conclusions and Relevance: In this discrete choice experiment of older adults in Beijing, influenza vaccination preferences were associated with vaccine profiles, trusted communication, and community-based service delivery. Prior vaccination history identified differences in benefit-risk weighting that may inform broad and targeted vaccination strategies.

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BibTeX
@article{jia2026influenza,
  title = {{Influenza Vaccination Preferences Among Adults Aged 60 Years and Older in Beijing, China}},
  author = {Mengmeng Jia and Yuxi Liu and Jiarui Zheng and Fenghua Su and Jitao Zhang and Mingyue Jiang and Tongsiman Wang and Xinqi Wang and Tao Wang and Wei Dai and Luzhao Feng},
  journal = {JAMA network open},
  year = {2026},
  month = oct,
  doi = {10.1001/jamanetworkopen.2026.38674},
  url = {https://europepmc.org/article/PMC/PMC13659565},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Influenza Vaccination Preferences Among Adults Aged 60 Years and Older in Beijing, China
AU  - Mengmeng Jia
AU  - Yuxi Liu
AU  - Jiarui Zheng
AU  - Fenghua Su
AU  - Jitao Zhang
AU  - Mingyue Jiang
AU  - Tongsiman Wang
AU  - Xinqi Wang
AU  - Tao Wang
AU  - Wei Dai
AU  - Luzhao Feng
PY  - 2026
DA  - 2026/10/01
JO  - JAMA network open
DO  - 10.1001/jamanetworkopen.2026.38674
UR  - https://europepmc.org/article/PMC/PMC13659565
AB  - Importance: Influenza vaccination coverage among older adults remains suboptimal in China despite free vaccination policies in some regions. Understanding their preferences may inform strategies to improve uptake.  Objective: To quantify preferences for influenza vaccination attributes and assess preference heterogeneity by prior influenza vaccination history.  Design, Setting, and Participants: This community-based survey study was conducted at 2 districts in Beijing, China, where influenza vaccination is provided free of charge for adults aged 60 years or older. A convenience sample of adults aged 60 years or older was included from 6 Beijing subdistricts and participated in a discrete choice experiment conducted from August to September 2025.  Main Outcomes and Measures: Stated choice among 2 hypothetical influenza vaccination profiles and an opt-out option. Attributes included vaccine effectiveness, risk of mild adverse effects, vaccination venue and operating hours, outreach method, information source, and message content. Conditional logit, mixed logit, scenario simulations, and vaccination-history interaction analyses were performed.  Results: Among 514 participants included in the analyses, the median age was 71 years (IQR, 65-79 years), and 356 (69.3%) were women. Higher vaccine effectiveness was associated with greater vaccination preference (β = 2.12; 95% CI, 1.37 to 2.88), whereas higher perceived risk of mild adverse effects was associated with lower preference (β = −5.53; 95% CI, −7.83 to −3.22). Participants preferred community-based vaccination settings, telephone reminders (β = 1.06; 95% CI, 0.76 to 1.36), information from government or community organizations (β = 0.78; 95% CI, 0.54 to 1.02), and messages emphasizing protection of family members (β = 0.50; 95% CI, 0.26 to 0.74). Increasing vaccine effectiveness from 20% to 80% and reducing perceived risk of adverse effects from 20% to 5% were associated with 30.74– and 19.96–percentage-point (pp) increases in the model-estimated choice probability, respectively. Compared with participants with prior vaccination, never-vaccinated participants had a greater preference for opting out (difference in β = 1.07; 95% CI, 0.11 to 2.03), greater sensitivity to mild adverse effect risk (difference in β per 10-pp increase, −0.49; 95% CI, −0.93 to −0.05), and lower responsiveness to vaccine effectiveness (difference in β per 10-pp increase, −0.18; 95% CI, −0.31 to −0.04).  Conclusions and Relevance: In this discrete choice experiment of older adults in Beijing, influenza vaccination preferences were associated with vaccine profiles, trusted communication, and community-based service delivery. Prior vaccination history identified differences in benefit-risk weighting that may inform broad and targeted vaccination strategies.
SN  - 2574-3805
ER  -