Factors associated with pneumococcal vaccine hesitancy and interventions to improve vaccine uptake in older adults: A narrative review using an established conceptual framework

Despite recommendations, pneumococcal vaccination rates in older adults remain suboptimal in many countries. This narrative review provides a comprehensive overview of the factors associated with pneumococcal vaccine hesitancy and potential interventions to address vaccine hesitancy, structured around the World Health Organization's Behavioural and Social Drivers of Vaccination (BeSD) framework as the guiding conceptual framework, and complemented by the 7C model of vaccination readiness. This review highlights the multifaceted challenge of hesitancy, which is influenced by psychological, social, and practical domains. Some interventions have been reported to improve pneumococcal vaccine uptake. Previous studies suggest that multicomponent approaches may be more promising than single-component strategies. Improving vaccine uptake requires a comprehensive understanding of the multiple drivers to inform the development of tailored strategies that address the relevant barriers in the target population.