{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:30:02Z","timestamp":1791862202686,"version":"4.3.4"},"reference-count":62,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004826","name":"Beijing Natural Science Foundation\u2013Haidian Original Innovation Joint Fund Project","doi-asserted-by":"publisher","award":["L242146"],"award-info":[{"award-number":["L242146"]}],"id":[{"id":"10.13039\/501100004826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: Influenza vaccination reduces morbidity and mortality in older adults. This study identifies characteristics and reasons for vaccination uptake among the elderly to inform strategies to improve coverage. Methods: We conducted a cross-sectional survey in December 2024 among community-dwelling adults aged \u2265 60 years across six Chinese cities. Data collected included socio-demographic and health characteristics, influenza vaccine awareness and uptake, reasons for vaccination or non-vaccination, and intentions for future vaccination. Univariate and multivariable logistic regression were used to identify factors associated with vaccination. To explore motivation patterns, co-occurrence networks of vaccination reasons were constructed, and k-medoids clustering was applied. Results: Among 13,363 adults aged \u2265 60 years, influenza vaccination coverage was 34.0%. Higher education and income, being married, having health insurance, poor self-care ability, and chronic obstructive pulmonary disease were independently associated with vaccination. Vaccinated individuals reported more positive attitudes and were mainly motivated by family and doctor recommendations as well as perceived vaccine effectiveness, with four motivation profiles discovered: social recommendation, comprehensive confidence, clinician-guided, and self-reliant confidence. Among unvaccinated participants, the main reasons for non-vaccination were mild influenza symptoms and the influence of family and friends, forming four motivation profiles: safety concern, low-perceived risk, social influence, and perceived ineffectiveness. Conclusions: Influenza vaccination among older Chinese adults remains suboptimal. Tailored interventions leveraging healthcare provider endorsement, family and social support, and policy-driven strategies such as free or subsidized vaccination are needed, particularly for high-risk populations.<\/jats:p>","DOI":"10.3390\/vaccines13111171","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T11:05:31Z","timestamp":1763463931000},"page":"1171","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Factors Associated with Influenza Vaccination Among Urban Community-Dwelling Chinese Elderly: Results from a Multicity Cross-Sectional Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Jiayue","family":"Guo","sequence":"first","affiliation":[{"name":"School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xitong","family":"Jiao","sequence":"additional","affiliation":[{"name":"School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA"},{"name":"Institute for Hospital Management, Tsinghua University, Shenzhen 518000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"You","sequence":"additional","affiliation":[{"name":"School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1016\/S0140-6736(17)33293-2","article-title":"Estimates of global seasonal influenza-associated respiratory mortality: A modelling study","volume":"391","author":"Iuliano","year":"2018","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1007\/s40520-019-01279-3","article-title":"The burden of influenza in older adults: Meeting the challenge","volume":"33","author":"Bartoszko","year":"2021","journal-title":"Aging Clin. 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