AUTHOR=Peng Rui , Peng Zongchao , Huang Siwen , Luo Sitong , Guo Dong 
  
TITLE=Psychosocial Determinants of Vaccine Hesitancy and Vaccination Behavior Among Older Adults in China: A Large Cross-Sectional Study
  
JOURNAL=International Journal of Public Health
  
VOLUME=Volume 71 - 2026
  
YEAR=2026
  
URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2026.1608705
  
DOI=10.3389/ijph.2026.1608705
  
ISSN=1661-8564
  
ABSTRACT=ObjectivesTo identify psychosocial determinants of vaccine hesitancy and vaccination behavior among older adults in China, using an integrated framework of the Health Belief Model and Theory of Planned Behavior.MethodsWe conducted a cross-sectional survey targeting individuals aged 60+ years during the pandemic vaccine rollout. The analysis included Probit regression models based on the Health Belief Model (HBM), Theory of Planned Behaviour (TPB), risk perception, vaccine confidence and behavioral intervention, with demographic and health status as control variables.ResultsAmong older adults, vaccine hesitancy was significantly associated with perceived benefits, perceived barriers, attitude, self-efficacy, concerns about vaccine safety, perceived vaccine necessity, positive incentives, negative social pressure, information prompts, and vaccination reminders. Actual vaccination behavior was significantly influenced by vaccine hesitancy, perceived severity, perceived benefits, perceived barriers, attitude, self-efficacy, and positive incentives, etc. Age and medical contraindications significantly affected both hesitancy and vaccine behavior.ConclusionThe integrated theoretical framework reveals age-specific behavioral pathways that are critical to vaccine acceptance among older Chinese adults. These findings underscore the importance of age-tailored interventions that address psychosocial barriers and leverage timely behavioral nudges to improve immunization outcomes in aging populations.