Abstract
BACKGROUND: Nursing homes are congregate settings for elderly individuals where infectious diseases can easily spread. The elderly are at high risk of contracting and dying from influenza, and the most effective way to prevent this is to receive the influenza vaccine. METHODS: This study conducted a cross-sectional survey of elderly people in nursing homes to investigate the occurrence of influenza symptoms during the 2024-2025 flu season, as well as vaccination status and reasons for receiving or not receiving the vaccine. Bivariate logistic regression was used to determine the factors influencing the vaccination rate. RESULTS: Of the 1024 elderly people who participated in the survey, 25.39% reported experiencing flu-related symptoms in the previous flu season. While 16.21% of the elderly expressed willingness to receive vaccination, only 5.57% actually received it. Influenza vaccination was positively correlated with educational attainment (aOR 3.800, 95% CI 1.480-9.758 for middle school; aOR 5.138, 95% CI 1.738-15.191 for high school), monthly household income (aOR 0.216, 95% CI 0.072-0.644 for >8000), ability for self-care (aOR 0.269, 95% CI 0.123-0.591), and the scale of the nursing home (aOR 9.033, 95% CI 1.531-53.305 for 151-299; aOR 2.629, 95% CI 1.359-5.084 for ≥300). Willingness to receive the influenza vaccination was positively correlated with an unhealthy health status (aOR 0.398, 95% CI 0.204-0.779), symptoms of influenza (aOR 2.730, 95% CI 1.861-4.007), nursing home location (aOR 1.537, 95% CI 1.099-2.941 for outer suburbs), and the scale of the nursing home (aOR 1.991, 95% CI 1.154-3.435 for 151-299; aOR 2.158, 95% CI 1.374-3.390 for ≥300). Most elderly people who received the vaccine believed that vaccination could effectively prevent flu and that it could reduce the risk of complications, the rest were not vaccinated due to concerns about adverse reactions, mobility issues, or the distance to vaccination sites. CONCLUSIONS: Low awareness of flu vaccines and physical inability to travel to vaccination sites may be potential barriers to receiving the flu vaccine. It is worrying that the influenza vaccination rate is low among the elderly in nursing homes in Shanghai. As a result, it is crucial to prioritize targeted monitoring and intervention strategies for vulnerable populations living in collective institutions.