tetano
Editor, Senior Moderator
Vaccine
. 2026 Apr 17:82:128588.
doi: 10.1016/j.vaccine.2026.128588. Online ahead of print.
Effectiveness of prescription-based influenza vaccination services among older adults in Binzhou, China: A cluster-randomized controlled trial
Lin Zhang[SUP] 1 [/SUP], Tao Lin[SUP] 1 [/SUP], Mengjie Wang[SUP] 1 [/SUP], Xiaohui Ma[SUP] 1 [/SUP], Huijuan Dong[SUP] 1 [/SUP], Jintong Song[SUP] 1 [/SUP], Yang Li[SUP] 2 [/SUP]
Affiliations
Introduction: Influenza poses a significant health risk to older adults in China, yet vaccination coverage remains low. This study evaluated the impact of prescription-based service models-with and without financial incentives-on influenza vaccine uptake among older adults.
Methods: We conducted a three-arm cluster-randomized controlled trial in Binzhou, China, involving 839 participants aged ≥60 years across five community health service centers (CHSCs). CHSCs were randomized to usual care (Group C), a prescription-based vaccination model (Group A), or the same model plus a small financial incentive (Group B). Participants in Group B received a waiver of the vaccination service fee (22 CNY), while vaccine costs remained self-paid. The primary outcome was influenza vaccination status during the 2025 season. A multivariable Generalized Estimating Equations (GEE) model was used to estimate odds ratios (ORs), accounting for cluster-level correlations and baseline covariates.
Results: Vaccination coverage was 9.55% in Group C, 30.86% in Group A, and 83.23% in Group B. Compared with usual care, the prescription-only model significantly increased uptake (OR = 3.51; 95% CI: 2.58-4.78), while the addition of a financial incentive further amplified the effect (OR = 69.47; 95% CI: 37.34-129.26). The intervention was effective across subgroups, including participants with low education, low income, or cognitive limitations.
Conclusion: Embedding influenza vaccination into outpatient prescription services-particularly when coupled with modest financial incentives-substantially increases vaccine uptake among older adults. This low-cost, scalable model holds promise for addressing immunization gaps in primary care and improving health equity in aging populations.
Keywords: Cluster randomized trial; Influenza vaccine; Older adults; Vaccine prescription.
. 2026 Apr 17:82:128588.
doi: 10.1016/j.vaccine.2026.128588. Online ahead of print.
Effectiveness of prescription-based influenza vaccination services among older adults in Binzhou, China: A cluster-randomized controlled trial
Lin Zhang[SUP] 1 [/SUP], Tao Lin[SUP] 1 [/SUP], Mengjie Wang[SUP] 1 [/SUP], Xiaohui Ma[SUP] 1 [/SUP], Huijuan Dong[SUP] 1 [/SUP], Jintong Song[SUP] 1 [/SUP], Yang Li[SUP] 2 [/SUP]
Affiliations
- PMID: 42000148
- DOI: 10.1016/j.vaccine.2026.128588
Introduction: Influenza poses a significant health risk to older adults in China, yet vaccination coverage remains low. This study evaluated the impact of prescription-based service models-with and without financial incentives-on influenza vaccine uptake among older adults.
Methods: We conducted a three-arm cluster-randomized controlled trial in Binzhou, China, involving 839 participants aged ≥60 years across five community health service centers (CHSCs). CHSCs were randomized to usual care (Group C), a prescription-based vaccination model (Group A), or the same model plus a small financial incentive (Group B). Participants in Group B received a waiver of the vaccination service fee (22 CNY), while vaccine costs remained self-paid. The primary outcome was influenza vaccination status during the 2025 season. A multivariable Generalized Estimating Equations (GEE) model was used to estimate odds ratios (ORs), accounting for cluster-level correlations and baseline covariates.
Results: Vaccination coverage was 9.55% in Group C, 30.86% in Group A, and 83.23% in Group B. Compared with usual care, the prescription-only model significantly increased uptake (OR = 3.51; 95% CI: 2.58-4.78), while the addition of a financial incentive further amplified the effect (OR = 69.47; 95% CI: 37.34-129.26). The intervention was effective across subgroups, including participants with low education, low income, or cognitive limitations.
Conclusion: Embedding influenza vaccination into outpatient prescription services-particularly when coupled with modest financial incentives-substantially increases vaccine uptake among older adults. This low-cost, scalable model holds promise for addressing immunization gaps in primary care and improving health equity in aging populations.
Keywords: Cluster randomized trial; Influenza vaccine; Older adults; Vaccine prescription.