Factors associated with willingness to accept pneumococcal vaccine based on the Health Belief Model among the elderly (≥60 years) living in Klang Valley, Malaysia

Understanding health behavior using the Health Belief Model (HBM) helps formulate strategies to improve the willingness, thereby increasing the acceptance of pneumococcal vaccination among the elderly. We aimed to assess the willingness to receive the pneumococcal vaccine and associated factors to inform pneumococcal vaccination policy for the elderly in Malaysia. We surveyed 402 elderly (60 years and above) selected from 14 Pusat Aktiviti Warga Emas (PAWE; Senior Citizen Activity Centers) in Klang Valley, Malaysia. Using a questionnaire, we gathered information on respondents' sociodemographic characteristics, self-reported knowledge of pneumococcal diseases, behavioral determinants using the HBM, trust in healthcare, trust in vaccines, and willingness to receive the pneumococcal vaccine. The mean age was 66.4 years (SD = 5.6). Only 29% had received at least one dose of pneumococcal vaccine, almost all of whom (93%) had received it before the Hajj or Umrah pilgrimage of Muslims. Mean willingness score was 8.20 (95% CI 8.01-8.39). Multiple linear regression analysis showed that elderly individuals were more willing to receive the pneumococcal vaccine if they perceived the disease as severe, had fewer barriers to vaccination, were influenced by prompts or encouragement to take action, and had greater trust in healthcare providers and the vaccine itself. The survey found low coverage for pneumococcal vaccination. Our findings suggest that improving information about pneumococcal disease, its severity, and the pneumococcal vaccine through health care providers to the elderly and their families would improve willingness to uptake the pneumococcal vaccine.