Abstract
Background: Influenza vaccine and pneumococcal vaccine are essential to protect the health of older adults. This study focuses on the impact of family physicians' recommendations on influenza and pneumococcal vaccine uptake among urban Chinese older adults and makes recommendations for improving vaccination rates. Methods: A cross-sectional survey on influenza vaccination and pneumonia vaccination was conducted in December 2024 in six cities in China among adults aged ≥60 years. Marginal effects as well as logistic regression models were adopted to measure the relationship between family physician recommendation and influenza vaccination and pneumonia vaccination. Results: The overall influenza vaccination rate was 34.05% and pneumococcal vaccination rate was 22.79%. City, educational level, monthly income, health status, and family physician vaccination recommendation had significant impacts on influenza and pneumococcal vaccination (p < 0.05). Among the investigated elderly population, 48.78% and 28.56% had received recommendations from family physicians regarding influenza and pneumococcal vaccination, respectively. Analysis of marginal effects models revealed that physicians' recommendations were significantly able to boost influenza and pneumococcal vaccination rates by 26.3% (average marginal effect = 0.263, 95% CI = 0.249-0.277) and 23.7% (average marginal effect = 0.237, 95% CI = 0.225-0.248), respectively (p < 0.001). In the adjusted model, family physician recommendation, compared with no family physician recommendation, was also associated with vaccine policy, monthly income, and age in influenza vaccine and pneumococcal vaccine uptake. Conclusions: Older adults' influenza and pneumococcal vaccination rates need to be improved. Family physicians' recommendations show a more significant impact on older adults. Family physician recommendations had the greatest boosting effect on vaccination among individuals aged 70-79. Healthcare providers should adopt different vaccine recommendation strategies based on the characteristics of older adults.