ArticleBMJ open2023
Factors influencing influenza, pneumococcal and shingles vaccine uptake and refusal in older adults: a population-based cross-sectional study in England.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 16 citations in OpenAlex.
- Review
- Uptake of Shingles, Influenza, COVID-19 and Pneumococcal Vaccination in Patients with Inflammatory Arthritis: A Three-Centre Study.Vaccines · 2026Article
- Factors determining first influenza vaccination among individuals with type 2 diabetes in the CONSTANCES cohort by age group (younger than 65 years or 65 and older).Human vaccines & immunotherapeutics · 2025Article
- Influenza Vaccination Appropriateness: Insights from the Local Health Unit of Catania During the 2023/2024 and 2024/2025 Seasons.Vaccines · 2025Article
- Long-term spatial patterns in COVID-19 booster vaccine uptake.Communications medicine · 2025Article
- Article
- Vaccine uptake, associated factors and reasons for vaccination status among the South African elderly; findings and next steps.PloS one · 2024Article
Corrections and comments
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Authors and funding
13 authors at 6 institutions in 2 countries.
Funding
Abstract
objectivesUptake of influenza, pneumococcal and shingles vaccines in older adults vary across regions and socioeconomic backgrounds. In this study, we study the coverage and factors associated with vaccination uptake, as well as refusal in the unvaccinated population and their associations with ethnicity, deprivation, household size and health conditions. DESIGN, SETTING AND
participantsThis is a cross-sectional study of adults aged 65 years or older in England, using a large primary care database. Associations of vaccine uptake and refusal in the unvaccinated with ethnicity, deprivation, household size and health conditions were modelled using multivariable logistic regression. OUTCOME MEASURE: Influenza, pneumococcal and shingles vaccine uptake and refusal (in the unvaccinated).
resultsThis study included 2 054 463 patients from 1318 general practices. 1 711 465 (83.3%) received at least one influenza vaccine, 1 391 228 (67.7%) pneumococcal vaccine and 690 783 (53.4%) shingles vaccine. Compared with White ethnicity, influenza vaccine uptake was lower in Chinese (OR 0.49; 95% CI 0.45 to 0.53), 'Other ethnic' groups (0.63; 95% CI 0.60 to 0.65), black Caribbean (0.68; 95% CI 0.64 to 0.71) and black African (0.72; 95% CI 0.68 to 0.77). There was generally lower vaccination uptake among more deprived individuals, people living in larger household sizes (three or more persons) and those with fewer health conditions. Among those who were unvaccinated, higher odds of refusal were associated with the black Caribbean ethnic group and marginally with increased deprivation, but not associated with higher refusal in those living in large households or those with lesser health conditions.
conclusionCertain ethnic minority groups, deprived populations, large households and 'healthier' individuals were less likely to receive a vaccine, although higher refusal was only associated with ethnicity and deprivation but not larger households nor healthier individuals. Understanding these may inform tailored public health messaging to different communities for equitable implementation of vaccination programmes.
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