Data Sheet 1_Self-perceptions of aging mediate the association between illness perception and influenza vaccine hesitancy in older adults with pneumonia during the 2024–2025 influenza season.docx

BackgroundAs population aging accelerates, pneumonia cases in older adults continue to rise. Although vaccination effectively prevents influenza and reduces secondary pneumonia risk, hesitancy persists in this demographic. Previous studies have explored the link between illness perception and vaccine hesitancy, but the role of self-perceptions of aging in their relationship remains unclear.
MethodsA cross-sectional study was conducted. From November 2024 to March 2025, 321 older pneumonia inpatients were recruited from a hospital in China. Data on illness perception, self-perceptions of aging, and influenza vaccine hesitancy were collected using the Brief Illness Perception Questionnaire, the brief version of the Attitudes to Aging Questionnaire, and the Influenza Vaccine Hesitancy Scale for individuals aged 60 years and above. Bootstrap sampling (replicates 5,000) was used to examine the mediating role of self-perceptions of aging.
ResultsAmong participants, 74.1% were unvaccinated. Illness perception positively correlated with influenza vaccine hesitancy (rs = 0.64, p < 0.01), while self-perceptions of aging negatively correlated with both (rs = −0.53, −0.75, p < 0.01). After controlling for covariates, an indirect association through self-perceptions of aging was observed in the relationship between illness perception and influenza vaccine hesitancy, accounting for 35.36% (95% CI: 22.56–51.39%) of the total association.
ConclusionThis study highlights the importance of self-perceptions of aging toward vaccine take-up among older pneumonia patients. Interventions targeting attitudes toward aging may represent new strategies for increasing influenza vaccination rates.

背景
随着人口老龄化进程加速，老年肺炎病例持续攀升。尽管疫苗接种可有效预防流感并降低继发性肺炎风险，但该群体的疫苗犹豫（vaccine hesitancy）问题依然存在。既往研究已探讨了疾病感知（illness perception）与疫苗犹豫之间的关联，但衰老自我感知（self-perceptions of aging）在二者关系中的作用仍不明晰。

方法
本研究采用横断面研究设计。2024年11月至2025年3月，从中国某医院招募了321名老年肺炎住院患者。采用简要疾病感知问卷（Brief Illness Perception Questionnaire）、衰老态度问卷简版（brief version of the Attitudes to Aging Questionnaire）以及针对60岁及以上人群的流感疫苗犹豫量表（Influenza Vaccine Hesitancy Scale），收集受试者的疾病感知、衰老自我感知与流感疫苗犹豫相关数据。采用Bootstrap抽样（重复抽样5000次）检验衰老自我感知的中介作用。

结果
受试对象中，74.1%未接种流感疫苗。疾病感知与流感疫苗犹豫呈正相关（rs = 0.64，p < 0.01），而衰老自我感知与二者均呈负相关（rs = −0.53，−0.75，p < 0.01）。控制协变量后，疾病感知与流感疫苗犹豫之间通过衰老自我感知形成的间接关联得以证实，该间接效应占总关联的35.36%（95% CI: 22.56–51.39%）。

结论
本研究证实了衰老自我感知对老年肺炎患者疫苗接种率的重要影响。针对衰老态度的干预措施，或可成为提升流感疫苗接种率的新策略。