Vaccine attitudes and acceptance among older adults in North Dakota: Understanding demographic characteristic variability.

Older adults face increased risks from infectious diseases which are often preventable with vaccines. The current study examines demographic variation in vaccine hesitancy among older adults in North Dakota. A mailed survey assessing age, gender, years of education, self-rated health, rurality, and political leaning as well as vaccine attitudes and vaccine acceptance was conducted with 739 older adults (65+), oversampled from rural counties. Vaccine hesitant attitudes were significantly higher among rural and politically-conservative older adults; whereas, vaccine acceptance was significantly higher among older, healthier, and politically-liberal older adults. Vaccine attitudes were significantly associated with vaccine acceptance and mediated the association between political leaning and vaccine acceptance. These findings highlight the demographic characteristics predictive of older adults' vaccine attitudes and acceptance. By better understanding the nuanced factors leading to hesitation to be vaccinated, practitioners can develop strategies to increase vaccination rates among this at-risk population.

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Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.