Aims: To examine the prevalence of influenza, pneumococcal, herpes zoster and COVID‑19 vaccine uptake in the older population, and determine associated sociodemographic and clinical determinants to identify potential barriers and equity of vaccine coverage.
Methods: A population‑based cross-sectional study was conducted using the Registry of Senior Australians National Historical Cohort. All individuals ³65 years receiving home care or residential aged care (RAC) in 2021 were included. Prevalence (95% CIs) of vaccine uptake was estimated by type of care support. Multivariable logistic regression estimated adjusted odds ratios (aORs, 95% CIs) for sociodemographic and clinical determinants of vaccine uptake.
Results: Among individuals receiving home care (n=225,460), prevalence of COVID-19 vaccination was 89.1% (89.0-89.3), influenza 74% (73.8-74.1), pneumococcal 30.7% (30.5-30.9) and zoster 10.7% (10.6-10.8). For RAC residents (n=234,246), prevalence of COVID-19 vaccination was 85.3% (85.2-85.5), influenza 54.4% (54.2-54.6), pneumococcal 13.2% (13.1-13.4) and zoster 4.3% (4.2-4.3). People living with dementia were 11-30% less likely to receive vaccines in both care settings (aOR 0.70, 0.68-0.71 to aOR 0.91, 0.88-0.93), as were culturally and linguistically diverse (CALD) individuals (aOR 0.64, 0.62-0.66 to aOR 0.93, 0.91-0.96). Individuals with greater socioeconomic disadvantage receiving home care were up to 37% less likely to receive COVID-19 and pneumococcal vaccinations.
Conclusions: Vaccination uptake was low in RAC, with concerningly low pneumococcal and herpes zoster coverage for both groups. Consistent disparities in vaccine uptake were observed for people living with dementia, CALD individuals and higher socioeconomic disadvantage, highlighting the need for targeted strategies to improve equity of immunisation among older Australians.