Vaccinating despite limited understanding: influenza vaccination behaviors among older adults in rural China under communication infrastructure theory

Influenza and its related illnesses are significant contributors to morbidity and mortality among older adults. While vaccination remains the most effective preventive measure, vaccination rates among older adults in rural China are alarmingly low. This study employs Communication Infrastructure Theory (CIT) to examine the factors influencing influenza vaccination uptake within this demographic. The research was conducted over four months, from December 2023 to March 2024, in a village in south-central Shanxi Province through participatory observation and semi-structured interviews with 24 elderly residents. The findings highlight the potential of CIT within rural China's acquaintance society. Specifically, micro-level storytelling networks, such as those involving family members and local healthcare providers, effectively promote vaccination uptake among older people. In contrast, the influence of meso-level storytelling remains limited, with community media platforms like village loudspeakers and rural WeChat groups showing minimal impact. Furthermore, critical access barriers, including low income and inadequate transportation, significantly hinder vaccination efforts. Based on these insights, this study proposes targeted strategies to enhance influenza vaccination rates among rural elderly populations globally, emphasizing the need to address communication and access barriers.