Singapore may rank high in its rate of Covid-19 vaccination. However, segments of the nation’s older adults, aged 71 to 75, were still reluctant to take the jab due to skepticism over the efficacy and safety of the vaccines. A study conducted by Singapore Management University’s (SMU) Centre for Research on Successful Ageing (ROSA) from February to June 2021 also revealed that respondents who did not intend to vaccinate were less socially integrated.

Covid-19 vaccines were rolled out to Singaporeans aged 70 and above on 22 February 2021, while those 60 and above could take theirs from mid-March 2021. Yet, 25% of older adults above 60 remained unvaccinated as of 24 June 2021. In contrast, 80% of individuals aged 12 to 39 received their doses, after their vaccinations began on 11 June 2021.

While the government has implemented additional initiatives to encourage older adults to vaccinate, including the availability of walk-ins without prior booking, the vaccination rate among older adults remains a concern.

“Vaccines are one of the first lines of defence in fighting a global pandemic,” shared Professor Paulin Straughan, Director, ROSA. “We hope that our collective work in surveying older adults through the Singapore Life Panel® enhances our understanding of what exactly is holding them back, and spurs more effective action that helps them to overcome their reservations towards vaccinations. To get to ‘Phase Endemic’, we need to protect our population, especially the elderly and vulnerable.”

Micah Tan, Research Associate at ROSA and lead author of the report, added, “Our findings suggest that we should try to understand the fears of older adults who have yet to vaccinate and support them by reassuring and guiding them through the vaccination process. This is especially so for family and friends of such individuals who play an important role in encouraging them. Only then can we provide them with the assurance they need to overcome their hesitation.”

Key research findings

Older adults less likely to have been vaccinated as of June 2021 tend to:

• be relatively older (aged 71-75)
• be of lower socioeconomic status (lower education levels and living in one to three-room HDB flats)
• have one or more chronic health conditions
• be less socially integrated (more likely to live alone, have fewer household members on average, or have fewer ‘close contacts’ on average).

Among the common reasons for delaying vaccination, 54.5% of respondents wanted to first sieve out potential reports of adverse side-effects from the vaccine. On the other hand, 25.71% preferred to have most Singaporeans in their age group vaccinated before they proceeded with theirs.

Fear about negative side-effects (79.23%) was the biggest reason for resisting vaccination, followed by not believing in any form of vaccination (25.6%).

Those who had no plans to vaccinate were least trusting of all sources of information on Covid-19 related news, including newspapers and government sources. They were, however, more willing to trust family members. This is congruent with findings from Straughan and Seow (2000) who also found that individuals were more likely to heed health advice from trusted personal contacts.

The older adults who resisted vaccines also had a greater likelihood of being less socially integrated. 14.58% of them lived alone in Singapore, compared to 7.05% who were fully vaccinated. The lack of social support meant they were less concerned and aware of the benefits and actual risks of being vaccinated. This explained the need for support by close contact to encourage them to vaccinate. For instance, family members and friends can play an instrumental role in helping these older adults register for the vaccine, accompany them for their appointments and care for them should they experience side effects.

Recommendations

Based on the findings, SMU ROSA recommends that government initiatives targeting the old to vaccinate should focus on individuals of lower socioeconomic status, especially those living in one to three-room HDB flats. These initiatives must assure older adults of the efficacy as well as the safety of the vaccines, convincing them that there are no significant health risks. This will be critical for those who may be of poorer health but are still eligible for vaccination.

As older adults are more keen to trust family members for sources of information, authorities can attempt to encourage them to vaccinate by reaching out to their younger relatives. Specific policies to encourage older adult vaccination could therefore involve enticing younger individuals to accompany their older family members to their vaccine appointments. Companies may consider allowing their employees to take time off work so that they can bring their older family members to take their doses. The government can also consider seeking volunteers to accompany these older adults to get their vaccinations. In the absence of family (particularly those living alone), community social support for seniors will be vital as we strive to bring more onboard the vaccination programme.

The study leveraged data collected by the Singapore Life Panel® (SLP), a population representative monthly survey of Singaporeans aged 56 to 75 in 2021, which has been conducted since 2015. The SLP has an average response rate of about 7,200 respondents per month. Accessed online, respondents could participate even during periods of full or partial social lockdown. From February to June 2021, the average response rate was 7,271 respondents per month, with 7,228 respondents participating in the June 2021 wave during which the survey was conducted.

Adapted from:
https://news.smu.edu.sg/news/2021/07/06/singapores-older-adults-resist-covid-19-vaccinations