Predictors of influenza vaccination among elderly: a cross-sectional survey in Greece

  • Ioannis Dardalas
  • Chryssa PourzitakiEmail author
  • Georgios Manomenidis
  • Faye Malliou
  • Petros Galanis
  • Georgios Papazisis
  • Dimitrios Kouvelas
  • Thalia Bellali
Original Article



Senior individuals are particularly vulnerable to influenza. Research suggests that protection against the virus and its transmission in this high-risk group of the population can be achieved by active immunization against the pathogen.


To explore and analyze the attitudes, knowledge and behavior of people over the age of 60 on influenza vaccination.

Population and methods

This cross-sectional survey included people over the age of 60 who were eligible candidates for the influenza vaccine from 3 regions from Northern and 1 region from Southern Greece. A self-completed questionnaire based upon the Theory of Planned Behaviour, the Motivation for Vaccination (MoVac-flu) and the Vaccination Advocacy Scale (MovAd) was administered to the participants. Demographic characteristics and information about health status were also obtained.


The final sample included 318 participants with mean age of 70.7 years. More than half of the participants (56.6%) had received a flu vaccine in 2018 while 50.8% received it annually in previous years. Behavioral (p < 0.001), normative (p < 0.001), and control beliefs (p < 0.001), promoted the uptake of the vaccine and the increased intention score (p < 0.001) was associated with increased probability of vaccination. Greater age (p = 0.001) and frequent visits to the doctors (p = 0.003) had a positive influence upon the uptake of the vaccine.


Only a small proportion of those over the age of 60 had received the influenza vaccine. This finding is worrying, as it indicates the impact that a future outbreak of seasonal influenza could exert upon vulnerable groups. There is an urgent need for further, better and more evidence-based information from healthcare professionals to achieve greater vaccination coverage in the community.


Influenza vaccination Influenza vaccine Elderly Theory of planned behavior 




Compliance with ethical standards

Conflict of interest

The authors declare that there are no conflicts of interest.

Ethical approval

Ethical approval was granted by the Bioethics Committee for the Faculty of Medicine of the Aristotle University of Thessaloniki (decision number1.56 21/11/18).

Statement of human rights

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (include name of committee + reference number) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Clinical Pharmacology, Faculty of Medicine, School of Health SciencesAristotle University of ThessalonikiThessaloníkiGreece
  2. 2.General Hospital of PtolemaidaPtolemaidaGreece
  3. 3.Center for Health Services Management and Evaluation, Faculty of NursingKapodistrian University of AthensAthensGreece
  4. 4.Faculty of Nursing“Alexander” Technological Educational Institute of ThessalonikiThessaloníkiGreece

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