Unravelling disparity in age-specific acceptance of COVID-19 vaccination: the contextual and psychosocial influences

Background: High COVID-19 vaccination uptake rates across all age groups are important for achieving herd immunity. However, age disparity in vaccination acceptance was consistently identified. Objective: Taking cues from tenets of socioemotional selectivity theory, this study examined how the contextual and psychosocial factors contributed to age-specific COVID-19 vaccination acceptance. Method: Four rounds of population-based cross-sectional surveys were conducted before and after the COVID-19 vaccination programme started in Hong Kong (n = 3527). Participants’ vaccination acceptance, trust in government, social norms, vaccine confidence and risk perception of COVID-19 were obtained. Vaccine-related news headlines were collected in the same timeframe. Result: Sentiment analysis found that the impact of negative news sentiment on vaccine hesitancy was greater among older people. The path analyses found that older people had greater trust in government, perceived greater influence of social norms, and had greater vaccine confidence which all in turn were associated with greater vaccination acceptance. However, older people were found to have less worry about contracting COVID-19, which somewhat lowered their vaccination acceptance. Conclusion: Communication to promote older people’s vaccination uptake should focus on promoting the government’s timely response to the negative news reports about vaccines and increasing the positive influences of social norms on their vaccination acceptance.