Abstract
BACKGROUND: In Armenia, although seasonal influenza vaccination (SIV) is recommended and free of charge for adults aged 65 and over, uptake remains low (18.1%). This study aimed to explore the factors influencing the uptake of SIV among older adults in Armenia. METHODS: Purposive convenience sampling was used to conduct semi-structured interviews among adults aged 65 and over to better understand knowledge and attitudes of SIV. Overall, 16 in-depth interviews (8 vaccinated and 8 unvaccinated) were conducted via phone. Inductive thematic analysis was used to understand the findings. RESULTS: Most participants had sufficient knowledge about seasonal influenza and SIV regardless of vaccination status. The most common reasons for not getting vaccinated were lack of trust in the vaccine’s safety and efficacy, absence of perceived severity and belief in their personal “strong immunity”, lack of and conflicting information, the possibility of infection after vaccination, and fear of allergic reactions. The most common reasons for vaccination were to avoid infection and its complications, prevent exacerbation of chronic diseases, and not burden family. Both vaccinated and unvaccinated participants trusted doctors for medical advice, yet almost all reported not receiving vaccination guidance from theirs. Most participants mentioned that the available information and advertisements about SIV were insufficient and suggested SMS reminders, TV advertisements, and doctors’ advice as the most effective ways to educate older adults. CONCLUSION: Although knowledge about seasonal influenza was acceptable, many older adults who were unvaccinated had misguided beliefs about SIV and their immune systems. Thus, this study highlights the importance of proper information dissemination to increase the uptake of SIV. To raise knowledge and awareness of SIV among older adults in Armenia, media campaigns utilizing TV advertisements and SMS messages should be employed, as well as training for physicians to encourage their recommendation of SIV among at-risk groups, especially those over 65. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-026-07355-4.