Authors (including presenting author) :
Shiu WH, Yau LM, Wong TK, Chan PF
Affiliation :
Department of Family Medicine and Primary Health Care, United Christian Hospital, Kowloon East Cluster
Introduction :
Vaccination is one of the most effective measures in combating COVID-19 worldwide. COVID-19 vaccination program has been commenced since 26 Feb 2021 in Hong Kong. According to the data of Centre for Health Protection in Nov 2021, the vaccination uptake rate in the elderly was undesirably low despite the fact that they were the most needy group (The vaccination rate were 61.76%, 43.32% and 16.37% for aged 60-69, 70-79 and 80 and above respectively). The reasons of vaccination hesitation of elderly need to be explored so that it can be addressed appropriately to enhance their vaccination rate.
Objectives :
-To review the medical history and current health status of those unvaccinated elderlies attending the clinic.
-To explore the medical and psychosocial barriers of vaccination for those unvaccinated elderlies by a modified 5C scale assessment tool during doctor consultation.
Methodology :
It was a 3-week cross-sectional survey conducted during the period from 6 Dec 2021 to 24 Dec 2021. Elderlies attending our clinic were randomly selected. To explore their medical and psychosocial barriers for vaccination, the attending doctor was asked to complete the Chinese version of a questionnaire modified from overseas studies (5C scale to assess the psychological antecedents of vaccination namely Confidence, Complacency, Constraints, Calculation and Collective responsibility), with addition of patients’ medical fitness consideration.
Result & Outcome :
There were 270 valid questionnaires analysed. The sex ratio was 1:1. The percentage of elderlies for aged 60-69, 70-79 and 80 and above were 22%, 35% and 43% respectively. Majority of them had at least 3 chronic diseases. The top 3 common diseases were hypertension (78%), hyperlipidemia (60%) and diabetic mellitus (56%). The three most common reasons for refusing vaccination were physical health concerns (the subgroup percentage for aged 60-69, 70-79 and 80 and above were 15%, 24% and 25% respectively), self-perceived low risk of being infected and safety concerns of the vaccine. They contributed to 64%, 13% and 9% of unvaccinated elderly respectively. For the top barrier (physical health concern), 92% elderly actually had no clinical contraindication for vaccination after doctors’ assessment.
Conclusion:
Number of elderly patients with physical health concerns (64%) far exceed those with psychological concerns (and the proportion rises with age). However, most of them did not have contraindication for vaccination. Measures like designated time for targeted explanation and education by physician-in-charge during their follow-up together with provision of on-site COVID-19 vaccination service might help boost up the vaccination rate in the elderlies.
