'Healthy ageing' messaging in vaccine promotion among older adults: evaluation of vaccine intention in a survey using a social marketing methodology.

BACKGROUND: Although increasing evidence suggests that vaccination may contribute to healthy ageing through benefits extending beyond infection prevention, vaccination coverage among older adults remains suboptimal in France. Social marketing offers a promising framework for promoting health behaviours by addressing multiple determinants of decision-making. This study aimed to identify key elements of the social marketing 5P framework that may improve vaccination intention and ultimately vaccination uptake. METHODS: We conducted a cross-sectional study among community-dwelling aged ≥60 years in France using an anonymous online questionnaire. Based on self-reported vaccine uptake and reasons for non-vaccination, participants were classified into three behavioural adherence profiles (low, intermediate, and high). Seven hypothetical scenarios related to vaccination promotion and access were presented. Differences between profiles were assessed using categorical analyses. RESULTS: Among 3331 respondents, 2416 were included. High-, intermediate-, and low-adherence profile represented 15.6%, 81.7% and 2.8% of participants. Agreement with the statement that vaccination contributes to healthy ageing increased from 3% in the low-adherence profile to 56% in the intermediate profile and 78% in the high profile (p < 0.001). Messages linking vaccination to reductions in stroke and myocardial infarction risk generated the highest vaccination intention, with 69% and 67% of participants in the High adherence profile reporting that they would get vaccinated, respectively. Healthcare professionals were the most trusted source of vaccination information (93-95% among intermediate and high adherence participants). Vaccination vouchers were positively received, with 57% of intermediate-adherence participants and 81% in the high-adherence reporting that they would get vaccinated if offered one. CONCLUSIONS: Messaging linking vaccination to healthy ageing, particularly though cardiovascular and cognitive health benefits, combined with trusted healthcare professionals and facilitated access to vaccination may improve vaccination intention among older adults, including those with intermediate adherence to vaccination recommendations. Further studies should assess whether these strategies translate into sustained improvements in vaccine uptake.