Abstract
BACKGROUND: Saxony-Anhalt (ST) has the oldest population in Germany, with partly above average and increasing prevalences of chronic diseases and multimorbidity. Vaccinations are crucial to prevent infections and severe disease outcomes in older adults, especially in rural areas. However, national immunisation recommendations for individuals aged 60 and above are only partially followed. This research aims to examine (1) actual vaccination utilization and (2) the determinants, reasons, and barriers to vaccination uptake in ST's elderly population (≥ 60 years). METHODS: (1) Vaccination utilization data from 760,868 individuals (aged ≥ 60 years ) for influenza, pneumococcus, and herpes zoster from 2011 to 2020 were analyzed using outpatient care data from the Central Research Institute for Outpatient Health Care in Germany (Zi). (2) Additionally, subjective vaccination behaviors, attitudes, and barriers were surveyed from 864 participants in two urban and two rural municipalities as part of the "Prevention in Old Age in Saxony-Anhalt" (PrimA LSA) project. RESULTS: The secondary data set included 760,868 individuals for influenza, pneumococcal, and herpes zoster vaccination. Immunisation rates for influenza and pneumococcus in ST were higher than the national average, but rates for herpes zoster were lower. A survey of 864 participants over 60 revealed that the subjective vaccination rate was overestimated. Key barriers included lack of information and limited access to vaccination services. The study also reaffirmed the central role of general practitioners in healthcare delivery. CONCLUSION: Despite positive attitudes towards vaccination, targeted educational initiatives are necessary to increase vaccination rates. General practitioners need additional support, and improving health literacy in the elderly is crucial to enhance vaccine acceptance and disease prevention.