Knowledge, attitudes and practices of vaccination among older adults in Brunei Darussalam: a convergent mixed-method study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objectives To determine the general vaccination knowledge, perceptions and uptake among older adults in Brunei Darussalam. Design Convergent mixed-methods study, integrating a cross-sectional knowledge, attitudes and practice (KAP) survey with a qualitative focus group discussion (FGD) component. Setting Five community-based older adult activity sites across Brunei. Participants A total of 142 community-dwelling adults aged ≥60 years participated in the KAP survey. Among them, 9 also joined the FGD sessions. Primary and secondary outcome measures The primary outcomes focused on vaccination-related KAP. Preferred sources of vaccination information were measured as a secondary outcome. Results Higher education attainment was associated with higher knowledge scores (college and above: mean difference=0.92 (95% CI 0.20 to 1.64)). Participants with chronic diseases reported more positive vaccination attitudes than those without (mean difference=−2.43 (95% CI −4.29 to −0.58)). Females (mean difference=−0.33 (95% CI −0.64 to −0.01)) and higher education attainment (secondary: 0.52 (95% CI 0.15 to 0.90); college and above: 0.66 (95% CI 0.25 to 1.07)) were associated with the ‘worry about unforeseen future effects’ attitude subscale. COVID-19 vaccine uptake was highest (86.6%), with free vaccination (85.9%) and family protection (83.1%) as key motivators, while concerns about side effects (38.0%) and insufficient information (37.3%) were significant barriers. Doctors (90.8%) and government-endorsed mass media (69.0%) were the most preferred sources. Qualitative findings highlighted COVID-19 as a cue for vaccine awareness, with vaccination practices driven mainly by perceived obligation following healthcare recommendations rather than personal intention, and firm trust in authorities alongside information gaps. Conclusion Vaccination practices were context-dependent and highly responsive to authoritative messaging. Sustaining adult vaccination beyond pandemic contexts requires public health strategies that prioritise trusted healthcare providers, transparent risk communication, and health-literacy-appropriate messaging for older adults. Strengthening routine clinician engagement and coordinated public communication is essential to support informed vaccination decisions and long-term vaccine confidence.
Source: BMJ Open
Language: English
Subfield: Health
Field: Social Sciences
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $1,839
OpenAlex ID: W7221141620