Evaluation of vaccine perceptions in Israel's Elderly: A Comparative study of COVID-19 and influenza vaccination attitudes

Purpose: This study aimed to evaluate the attitudes of Israeli elderly population towards COVID-19 and influenza vaccines, and to assess factors contributing to these attitudes. Methods: Four-hundred and one participants exhibiting symptoms consistent with COVID-19 or influenza were enrolled and filled out a questionnaire. A second questionnaire was filled out for hospitalized patients at discharge. Nasopharyngeal samples were collected and detected for COVID-19 and influenza presence by reverse transcription PCR. Participants were divided into 3 groups according to their attitude towards vaccine- Provaccine, Anti-vaccine and Dependent group, which represented participants whose stance depended on disease infection rate. Results: Out of 401 participants, 11.2% (45/401) tested positive for COVID-19, 10.5% (42/401) were positive for Influenza A and one (0.2%) patient had Influenza B. The participants expressed varied beliefs about COVID-19 vaccine: 14.7% (59/401) agreed that it causes disease, 25.4% (102/401) doubted vaccine effectiveness and 22.9% (92/401) questioned vaccine safety. A higher percentage of individuals in Pro-Vaccine group (66.3%, 179/270) as compared to Anti-Vaccine (45.3%, 24/53) and to Dependent (60.3%, 47/78) groups had a COVID19 history. Hospitalization history was significantly more common in Pro-Vaccine (11.1%, 30/270) and Dependent groups (16.7%, 13/78) than in Anti-Vaccine group (1.9%, 1/53). Influenza vaccine effectiveness was doubted by 19.7% (79/401), 18% (72/401) participants questioned safety, and 18.7% (75/401) agreed that the vaccine causes disease. The majority of both Dependent (54.2%, 13/24) and Pro-Vaccine (56.2%, 167/297) groups believed they received sufficient information about the vaccine, while only 25% (20/80) of the Anti-Vaccine group has similar impressions. Conclusions: This analysis reveals a notable disinclination towards vaccination among some of the elderly, reflecting their deep and ingrained hesitancy. These findings emphasize the need for customized approaches to improve vaccine acceptance in this vulnerable group. Such strategies should consider the various motivations and influences shaping elderly perspectives, from individual health experiences to wider social and cultural factors.