Determinants of vaccine adherence and hesitancy in older adults in Brazil: an integrative review

Abstract

Objective:  analyzed factors influencing vaccine adherence and hesitancy among elderly people in Brazil. Method: An integrative review was conducted to answer: “What factors are related to non-adherence and vaccine hesitancy among the elderly in Brazil?” A systematic search was performed in PubMed, SciELO, CAPES Portal, and the Virtual Health Library. The strategy used Health Sciences Descriptors (DeCS) — “Vaccination Coverage,” “Aged”, “Vaccination,” “Vaccine hesitancy” — and Medical Subject Headings (MeSH), combined with the Boolean operator AND. Independent reviewers conducted the selection. Full articles published in the last ten years, in Portuguese, English, and Spanish, were included, following the PRISMA flowchart. Screening occurred in three stages: title reading, abstract review, and full-text analysis. Twelve articles were selected, and data were extracted and categorized using an adapted instrument. Results: Findings were grouped into three categories: (1) impact of health professionals and access to services; (2) sociodemographic profile and post-pandemic context; and (3) influence of social networks. Health professionals were essential to expand coverage through clear guidance and educational campaigns. The post-pandemic period increased insecurity and reinforced the importance of official sources to mitigate hesitancy. Conclusion: Vaccine adherence among the elderly is influenced by socioeconomic, cultural, and informational factors. Strengthening communication between health professionals and the population, alongside educational strategies and combating misinformation, is essential to reduce hesitancy and expand coverage nationwide.