Do Family Physicians’ Recommendations for Influenza and Pneumococcal Vaccines Impact the Elderly Aged ≥60 Years? A Cross-Sectional Study in Six Chinese Cities
Abstract
1. Introduction
2. Method
2.1. Study Design and Participants
2.2. Measures
2.3. Statistical Analysis
3. Result
3.1. Population Characteristics and Factors Associated with Vaccination
3.2. Analysis of Marginal Effects of Family Physicians’ Recommendations
3.3. Vaccine Policy Differences in the Probability of Influenza Vaccine and Pneumococcal Vaccine with Family Physician’s Recommendation and No Family Physician’s Recommendation
3.4. Age-Group Differences in the Probability of Influenza Vaccine and Pneumococcal Vaccine with Family Physician Recommendation and No Family Physician Recommendation
3.5. Gender Differences in the Probability of Influenza Vaccine and Pneumococcal Vaccine with Family Physician Recommendation and No Family Physician Recommendation
3.6. Monthly Income Differences in the Probability of Influenza Vaccine and Pneumococcal Vaccine with Family Physician Recommendation and No Family Physician Recommendation
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Demographic Characteristics | N | % | |
---|---|---|---|
City | Beijing | 2180 | 16.31 |
Chengdu | 2059 | 15.41 | |
Hangzhou | 2208 | 16.52 | |
Qingdao | 2140 | 16.01 | |
Shenzhen | 2253 | 16.86 | |
Chongqing | 2523 | 18.88 | |
Gender | Male | 6048 | 45.26 |
Female | 7315 | 54.74 | |
Age | 60–69 | 7678 | 57.46 |
70–79 | 4302 | 32.19 | |
≥80 | 1383 | 10.35 | |
Ethnicity | Han | 13,073 | 97.83 |
Minorities | 290 | 2.17 | |
Education Level | Primary School and Below | 3720 | 27.84 |
Junior High School | 3992 | 29.87 | |
Senior High School | 3461 | 25.90 | |
Bachelor’s Degree | 2050 | 15.34 | |
Postgraduate | 140 | 1.05 | |
Monthly Income (CNY *) | ≤2500 | 3850 | 28.81 |
2501–5000 | 5829 | 43.62 | |
5001–7500 | 2457 | 18.39 | |
>7500 | 1227 | 9.18 | |
Health Status | Very Poor | 215 | 1.61 |
Poor | 1188 | 8.89 | |
Fair | 5367 | 40.16 | |
Good | 5421 | 40.57 | |
Very Good | 1172 | 8.77 | |
Vaccine Price (Influenza Vaccination) | Self-pay | 8813 | 65.95 |
Free | 4550 | 34.05 | |
Vaccine Price (Pneumococcal Vaccination) | Self-pay | 10,317 | 77.21 |
Free | 3046 | 22.79 | |
Vaccine Uptake (Influenza Vaccination) | No | 8813 | 65.95 |
Yes | 4550 | 34.05 | |
Vaccine Uptake (Pneumococcal Vaccination) | No | 10,317 | 77.21 |
Yes | 3046 | 22.79 | |
Family Physician Vaccination Recommendation (Influenza Vaccination) | No | 6845 | 51.22 |
Yes | 6518 | 48.78 | |
Family Physician Vaccination Recommendation (Pneumococcal Vaccination) | No | 9546 | 71.44 |
Yes | 3817 | 28.56 |
Variable | Influenza Vaccine | Pneumococcal Vaccine | |||||||
---|---|---|---|---|---|---|---|---|---|
Non-Vaccinated | Vaccinated | p-Value | χ2 | Non-Vaccinated | Vaccinated | p-Value | χ2 | ||
N (%) | N (%) | N (%) | N (%) | ||||||
City | Beijing | 1472 (67.52%) | 708 (32.48%) | <0.001 | 187.684 | 1659 (76.10%) | 521 (23.90%) | <0.001 | 271.66 |
Chengdu | 1414 (68.67%) | 645 (31.33%) | 1367 (66.39%) | 692 (33.61%) | |||||
Hangzhou | 1195 (54.12%) | 1013 (45.88%) | 1655 (74.95%) | 553 (25.05%) | |||||
Qingdao | 1540 (71.96%) | 600 (28.04%) | 1637 (76.50%) | 503 (23.50%) | |||||
Shenzhen | 1470 (65.25%) | 783 (34.75%) | 1934 (85.84%) | 319 (14.16%) | |||||
Chongqing | 1722 (68.25%) | 801 (31.75%) | 2065 (81.85%) | 458 (18.15%) | |||||
Gender | Male | 3938 (65.11%) | 2110 (34.89%) | 0.063 | 3.458 | 4635 (76.64%) | 1413 (23.36%) | 0.154 | 2.031 |
Female | 4875 (66.64%) | 2440 (33.36%) | 5682 (77.68%) | 1633 (22.32%) | |||||
Age | 60–69 | 5038 (65.62%) | 2640 (34.38%) | 1.383 | 0.501 | 5929 (77.22%) | 1749 (22.78%) | 0.318 | 2.289 |
70–79 | 2846 (66.16%) | 1456 (33.84%) | 3300 (76.71%) | 1002 (23.29%) | |||||
≥80 | 929 (67.17%) | 454 (32.83%) | 1088 (78.67%) | 295 (21.33%) | |||||
Ethnicity | Han Chinese | 8628 (66.00%) | 4445 (34.00%) | 0.433 | 0.007 | 10,100 (77.26%) | 2973 (22.74%) | 0.329 | 0.953 |
Minorities | 185 (63.79%) | 105 (36.21%) | 217 (74.83%) | 73 (25.17%) | |||||
Education Level | Primary School and Below | 2677 (71.96%) | 1043 (28.04%) | <0.001 | 99.695 | 2972 (79.89%) | 748 (20.11%) | <0.001 | 59.038 |
Junior High School | 2609 (65.36%) | 1383 (34.64%) | 3100 (77.66%) | 892 (22.34%) | |||||
Senior High School | 2205 (63.71%) | 1256 (36.29%) | 2680 (77.43%) | 781 (22.57%) | |||||
Bachelor’s Degree | 1243 (60.63%) | 807 (39.37%) | 1472 (71.80%) | 578 (28.20%) | |||||
Postgraduate | 79 (56.43%) | 61 (43.57%) | 93 (66.43%) | 47 (33.57%) | |||||
Monthly Income (CNY) | ≤2500 | 2849 (74.00%) | 1001 (26.00%) | <0.001 | 157.152 | 3095 (80.39%) | 755 (19.61%) | <0.001 | 36.476 |
2501—5000 | 3676 (63.06%) | 2153 (36.94%) | 4458 (76.48%) | 1371 (23.52%) | |||||
5001—7500 | 1520 (61.86%) | 937 (38.14%) | 1824 (74.24%) | 633 (25.76%) | |||||
≥7500 | 768 (62.59%) | 459 (37.41%) | 940 (76.61%) | 287 (23.39%) | |||||
Health Status | Very Poor | 125 (58.14%) | 90 (41.86%) | 0.004 | 15.594 | 132 (61.40%) | 83 (38.60%) | <0.001 | 52.851 |
Poor | 813 (68.43%) | 375 (31.57%) | 954 (80.30%) | 234 (19.70%) | |||||
Fair | 3599 (67.06%) | 1768 (32.94%) | 4214 (78.52%) | 1153 (21.48%) | |||||
Good | 3519 (64.91%) | 1902 (35.09%) | 4157 (76.68%) | 1264 (23.32%) | |||||
Very Good | 757 (64.59%) | 415 (35.41%) | 860 (73.38%) | 312 (26.62%) | |||||
Family Physician Vaccination Recommendation | No | 5405 (78.96%) | 1440 (21.04%) | <0.001 | 1058.091 | 8145 (85.32%) | 1401 (14.68%) | <0.001 | 1251.479 |
Yes | 3408 (52.29%) | 3110 (47.71%) | 2172 (56.90%) | 1645 (43.10%) | |||||
Vaccine Price | Self-pay | 5871 (66.62%) | 2942 (33.38%) | 0.476 | 0.509 | 4279 (41.48%) | 6038 (58.52%) | 0.445 | 0.584 |
Free | 3059 (67.23%) | 1491 (32.77%) | 1287 (42.25%) | 1759 (57.75%) |
Family Physician Recommendation | Vaccine Price | Influenza Vaccine | Pneumococcal Vaccine | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Unadjusted | Adjusted | Unadjusted | Adjusted | ||||||||||||
Vaccinated (%) | p-Value | Vaccinated (%) a | Effect of Vaccine Price by Family Physician Recommendation (pp) b | 95% CI | Effect of Physician Family Recommendation by Vaccine Price (pp) c | 95% CI | Vaccinated (%) | p-Value | Vaccinated (%) a | Effect of Vaccine Price by Family Physician Recommendation (pp) b | 95% CI | Effect of Family Physician Recommendation by Vaccine Price (pp) c | 95% CI | ||
No | Self-pay | 18.50% | <0.001 | 19.89% | reference | reference | 14.90% | 0.622 | 14.38% | reference | reference | ||||
Free | 24.40% | 21.53% | 1.64% | (0.002,0.031) * | reference | 14.50% | 14.53% | 0.15% | (−0.010, 0.011) | reference | |||||
Yes | Self-pay | 46.50% | <0.001 | 47.36% | reference | 27.47% | (0.259, 0.290) * | 41.60% | 0.103 | 43.16% | reference | 28.78% | (0.266, 0.304) * | ||
Free | 51.70% | 49.86% | 2.50% | (0.003,0.047) * | 28.33% | (0.265, 0.301) * | 44.30% | 43.44% | 0.28% | (−0.019, 0.023) | 28.91% | (0.267, 0.305) * |
Family Physician Recommendation | Age | Influenza Vaccine | Pneumococcal Vaccine | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Unadjusted | Adjusted | Unadjusted | Adjusted | ||||||||||||
Vaccinated (%) | p-Value | Vaccinated (%) a | Effect of Age by Family Physician Recommendation (pp) b | 95% CI | Effect of Family Physician Recommendation by Age (pp) c | 95% CI | Vaccinated (%) | p-Value | Vaccinated (%) a | Effect of Age by Family Physician Recommendation (pp) b | 95% CI | Effect of Family Physician Recommendation by Age (pp) c | 95% CI | ||
No | 60–69 | 19.70% | 0.004 | 21.37% | reference | reference | 14.20% | 0.025 | 14.12% | reference | reference | ||||
70–79 | 23.30% | 22.28% | 0.91% | (−0.005,0.024) | reference | 16.00% | 15.41% | 1.29% | (0.001,0.025) * | reference | |||||
≥80 | 20.90% | 20.47% | −0.90% | (−0.030,0.013) | reference | 13.10% | 13.93% | −0.19% | (−0.020,0.016) | reference | |||||
Yes | 60–69 | 49.30% | 0.004 | 49.48% | reference | 28.11% | (0.267, 0.300) * | 43.60% | 0.643 | 42.68% | reference | 28.56% | (0.267, 0.304) * | ||
70–79 | 46.30% | 50.81% | 1.33% | (−0.008,0.034) | 28.53% | (0.270, 0.305) * | 42.70% | 45.21% | 2.53% | (0.002,0.049) * | 29.80% | (0.277, 0.317) * | |||
≥80 | 43.30% | 48.12% | −1.36% | (−0.046,0.019) | 27.65% | (0.260, 0.298) * | 41.30% | 42.30% | −0.38% | (0.033,0.838) * | 28.37% | (0.277, 0.317) * |
Family Physician Recommendation | Gender | Influenza Vaccine | Pneumococcal Vaccine | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Unadjusted | Adjusted | Unadjusted | Adjusted | ||||||||||||
Vaccinated (%) | p-Value | Vaccinated (%) a | Effect of Gender by Family Physician Recommendation (pp) b | 95% CI | Effect of Family Physician Recommendation by Gender (pp) c | 95% CI | Vaccinated (%) | p-Value | Vaccinated (%) a | Effect of Gender by Family Physician Recommendation (pp) b | 95% CI | Effect of Family Physician Recommendation by Gender (pp) c | 95% CI | ||
No | Male | 20.30% | 0.188 | 19.72% | reference | reference | 14.50% | 0.651 | 14.48% | reference | reference | ||||
Female | 21.60% | 20.02% | 0.30% | (−0.009, 0.015) | reference | 14.80% | 14.56% | 0.08% | (−0.010, 0.012) | reference | |||||
Yes | Male | 49.10% | 0.029 | 47.11% | reference | 27.39% | (0.262, 0.296) * | 44.40% | 0.114 | 43.36% | reference | 28.88% | (0.270, 0.306) * | ||
Female | 46.40% | 47.57% | 0.46% | (−0.014, 0.024) | 27.55% | (0.264, 0.298) * | 41.90% | 43.51% | 0.15% | (−0.020, 0.023) | 28.95% | (0.271, 0.307) * |
Family Physician Recommendation | Monthly Income (CNY) | Influenza Vaccine | Pneumococcal Vaccine | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Unadjusted | Adjusted | Unadjusted | Adjusted | ||||||||||||
Vaccinated (%) | p-Value | Vaccinated (%) a | Effect of Monthly Income by Family Physician Recommendation (pp) b | 95% CI | Effect of Family Physician Recommendation by Monthly Income (pp) c | 95% CI | Vaccinated (%) | p-Value | Vaccinated (%) a | Effect of Monthly Income by Family Physician Recommendation (pp) b | 95% CI | Effect of Family Physician Recommendation by Monthly Income (pp) c | 95% CI | ||
No | <2500 | 13.70% | <0.001 | 15.83% | reference | reference | 13.23% | <0.001 | 12.25% | reference | reference | ||||
2500–5000 | 22.10% | 21.37% | 5.54% | (0.041, 0.070) * | reference | 14.06% | 14.41% | 2.16% | (0.010,0.034) * | reference | |||||
5000–7500 | 25.70% | 22.36% | 6.53% | (0.044, 0.087) * | reference | 16.09% | 18.08% | 5.83% | (0.042,0.075) * | reference | |||||
>7500 | 29.30% | 20.16% | 4.33% | (0.016, 0.070) * | reference | 13.28% | 16.23% | 3.98% | (0.019,0.061) * | reference | |||||
Yes | <2500 | 40.00% | <0.001 | 40.39% | reference | 24.56% | (0.232, 0.266) * | 40.92% | <0.001 | 38.54% | reference | 27.69% | (0.256, 0.297) * | ||
2500–5000 | 50.10% | 49.48% | 9.09% | (0.067, 0.115) * | 28.11% | (0.267, 0.300) * | 42.62% | 43.06% | 4.52% | (0.020,0.070) * | 28.56% | (0.267, 0.304) * | |||
5000–7500 | 54.00% | 50.92% | 10.53% | (0.072, 0.139) * | 28.56% | (0.270, 0.306) * | 46.55% | 49.79% | 11.25% | (0.082,0.144) * | 30.46% | (0.282, 0.326) * | |||
>7500 | 47.20% | 47.63% | 7.24% | (0.029, 0.116) * | 27.47% | (0.258, 0.297) * | 41.01% | 46.53% | 7.99% | (0.040,0.120) * | 27.73% | (0.250, 0.304) * |
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Wang, Y.; Dai, J.; Yuan, S.; Chen, Y.; Zhang, Z.; Zhu, L.; Liu, G.; Zeng, Q.; Qiu, Q.; Luo, C.; et al. Do Family Physicians’ Recommendations for Influenza and Pneumococcal Vaccines Impact the Elderly Aged ≥60 Years? A Cross-Sectional Study in Six Chinese Cities. Vaccines 2025, 13, 886. https://doi.org/10.3390/vaccines13080886
Wang Y, Dai J, Yuan S, Chen Y, Zhang Z, Zhu L, Liu G, Zeng Q, Qiu Q, Luo C, et al. Do Family Physicians’ Recommendations for Influenza and Pneumococcal Vaccines Impact the Elderly Aged ≥60 Years? A Cross-Sectional Study in Six Chinese Cities. Vaccines. 2025; 13(8):886. https://doi.org/10.3390/vaccines13080886
Chicago/Turabian StyleWang, Yuxing, Jianing Dai, Shuai Yuan, Ying Chen, Zhujiazi Zhang, Ling Zhu, Gang Liu, Qiang Zeng, Qian Qiu, Chunyu Luo, and et al. 2025. "Do Family Physicians’ Recommendations for Influenza and Pneumococcal Vaccines Impact the Elderly Aged ≥60 Years? A Cross-Sectional Study in Six Chinese Cities" Vaccines 13, no. 8: 886. https://doi.org/10.3390/vaccines13080886
APA StyleWang, Y., Dai, J., Yuan, S., Chen, Y., Zhang, Z., Zhu, L., Liu, G., Zeng, Q., Qiu, Q., Luo, C., Deng, R., & You, L. (2025). Do Family Physicians’ Recommendations for Influenza and Pneumococcal Vaccines Impact the Elderly Aged ≥60 Years? A Cross-Sectional Study in Six Chinese Cities. Vaccines, 13(8), 886. https://doi.org/10.3390/vaccines13080886