Vaccination is a cornerstone of public health, particularly vital for older adults who are at increased risk of morbidity and mortality from vaccine-preventable diseases due to age-related immune decline. Despite advances in vaccine technology and accessibility, awareness and acceptance rates remain suboptimal in adults aged above 50 years, thereby limiting the full benefits of immunization programs globally. Studies have shown that adults in this age group frequently lack adequate knowledge about recommended vaccines, including influenza, pneumococcal, and herpes zoster vaccines, leading to underutilization of preventive healthcare services [1,2].

For instance, Di Giuseppe et al. found that although the willingness to receive the herpes zoster vaccine was generally positive among Italian adults, it was significantly influenced by knowledge levels and healthcare provider recommendations [1]. Similar findings were echoed in Saudi Arabia, where Alsuhebany et al. highlighted significant gaps in vaccination perception even after the COVID-19 vaccine was mandated, underscoring the role of personal belief and misinformation [2].

Attitudinal factors such as fear of side effects, skepticism towards vaccine efficacy, and reliance on natural immunity are well-documented barriers to adult vaccination [3]. Alhothali et al. conducted a population-based study in the western region of Saudi Arabia, revealing that misconceptions about vaccine safety and a lack of proactive physician communication led to hesitancy towards the herpes zoster vaccine [3]. This underlines the importance of strategic public education and healthcare provider engagement in boosting vaccine uptake.

Healthcare provider attitudes are also pivotal in influencing adult vaccination behavior. A survey by Hurley et al. explored physicians’ perspectives on the updated PCV13 vaccine guidelines for adults aged ≥65 years and found inconsistent application of recommendations due to ambiguity in guidelines and lack of training [4]. Hence, both patient and provider education are critical components in increasing vaccine adherence among older adults.

Moreover, occupational studies, such as that by Wang et al. on healthcare workers in China, emphasize that even medical professionals demonstrate variability in vaccine willingness based on perceived risk and trust in vaccine efficacy [5]. This variability is mirrored in other occupational groups, including dental practitioners and general physicians, who serve as crucial points of information for older patients [6].

Cultural factors and socioeconomic status further compound vaccine hesitancy. Lindsay et al. documented that Central American immigrant parents exhibited low awareness of HPV vaccines for their children, largely driven by access barriers and limited health literacy, which may similarly affect older populations [7].

Tao et al. demonstrated the success of community interventions in improving influenza vaccine uptake among diabetic patients, suggesting that localized, culturally sensitive awareness programs can positively influence behavior [8]. Additionally, acceptance of newer vaccines like the shingles vaccine is often driven by knowledge of disease severity, as shown by Bricout et al. in the UK [9].

Lastly, a U.S. national survey by Nowak et al. revealed that understanding the rationale behind vaccine recommendations was associated with increased acceptance rates, pointing to the need for clear, evidence-based public messaging [10].

In light of these diverse influences, this study aims to estimate the level of awareness and attitudes toward vaccination among adults aged over 50 years, providing insights that can aid in designing effective interventions to bridge the existing gaps in adult immunization.