Abstract
The proportion of the population vaccinated in Israel against COVID-19 in 2021 was significantly higher than that of the annual uptake rates of the influenza vaccine over time. Understanding the reasons behind the high vaccination rate may facilitate maintaining these rates if annual COVID-19 vaccination is required. Using a mixed-methods design, we characterized the individuals who were vaccinated and studied their attitudes toward vaccines and motivators for the COVID-19 vaccine. The first part was a cross-sectional study of adults aged 65 and over who were vaccinated against COVID-19. We stratified them according to their annual influenza vaccination patterns, and compared variables such as age, gender, health status, and timing of COVID-19 vaccination. The second part consisted of a questionnaire administered to a subsample of the above population, inquiring about vaccine hesitancy, motivators for vaccination, and intention to be vaccinated in the future. We found that motivating factors for COVID-19 vaccination are similar between those who regularly vaccinate against influenza and those who don't. Internal motivators such as perceived vaccine effectiveness and the desire to protect others were stronger than external rewards or sanctions. High adherence to annual influenza vaccine recommendations was associated with earlier COVID-19 vaccine uptake. Respondents with lower adherence to influenza vaccines were more likely to demonstrate higher levels of vaccine hesitancy. These factors should be addressed in future vaccination campaigns.