The elderly are a priority population for COVID-19 vaccination. COVID-19 vaccination can effectively reduce the risk of developing severe and critically ill patients or even death in COVID-19 patients. However, the current vaccination rate of the elderly in China is relatively low, and the COVID-19 vaccination behavior among the elderly has been rarely reported in current studies.

To investigate COVID-19 vaccination behavior and its influencing factors among the elderly in China, and to provide a reference for improving the COVID-19 vaccination rate of the elderly.

A total of 1 323 older adults aged 60 years and above in Wujin District of Changzhou City, Zhongmu County of Zhengzhou City, Chengzhong District of Xining City and Linkou County of Mudanjiang City were selected as research subjects from August 3 to August 14 in 2022 by using a stratified random sampling method and investigated by self-designed questionnaires. Binary Logistic regression analysis was used to explore the influencing factors of the first dose of COVID-19 vaccination, full course of COVID-19 vaccination, and booster dose of COVID-19 vaccination.

96.60% (1 278/1 323) of the elderly received the first dose of COVID-19 vaccine, 91.76% (1 214/1 323) completed the full course of COVID-19 vaccination, and 79.67% (1 054/1 323) received the booster dose of COVID-19 vaccine. The results of binary Logistic regression analysis showed that compared with the older adults aged 60-64 years, the older adults aged 75 years and above were less likely to receive the first dose of the COVID-19 vaccine〔OR (95%CI) =0.27 (0.11, 0.62), P<0.05〕; compared with the older adults with chronic disease, the older adults without chronic disease were more likely to receive the first dose of COVID-19 vaccine〔OR (95%CI) =2.07 (1.12, 3.84), P<0.05〕; the older adults with higher levels of perceived benefit were more likely to receive the first dose of COVID-19 vaccine〔OR (95%CI) =1.39 (1.07, 1.79), P<0.05〕. Compared with the older adults aged 60-64 years, who maintained regular physical exercise, those aged 75 years and above〔OR (95%CI) =0.34 (0.19, 0.59), P<0.05〕, who did not maintain regular physical exercise〔OR (95%CI) =0.64 (0.42, 0.96), P<0.05〕were less likely to complete the full course of vaccination; compared with the older adults with chronic diseases, the older adults without chronic diseases were more likely to complete the full course of the COVID-19 vaccination〔OR (95%CI) =1.59 (1.05, 2.40), P<0.05〕. Compared with older adults aged 60-64 years and from the central region, the older adults aged 75 years and above〔OR (95%CI) =0.55 (0.36, 0.86), P<0.05〕and from the eastern region〔OR (95%CI) =0.47 (0.34, 0.64), P<0.05〕were less likely to receive the booster dose of COVID-19 vaccine; compared with the older adults with chronic diseases, the older adults without chronic diseases were more likely to receive the booster dose of COVID-19 vaccine〔OR (95%CI) =1.54 (1.15, 2.06), P<0.05〕; older adults with higher levels of perceived severity were more likely to receive the booster dose of COVID-19 vaccine〔OR (95%CI) =1.06 (1.00, 1.11), P<0.05〕. Subgroup analysis showed that compared with the older adults with chronic diseases aged 60-64 years, from the central region, older adults with chronic diseases aged 75 years and above〔OR (95%CI) =0.35 (0.19, 0.65), P<0.05〕, from the eastern region〔OR (95%CI) =0.49 (0.29, 0.83), P<0.05〕were less likely to receive the booster dose of COVID-19 vaccine; older adults with chronic diseases who had higher levels of perceived severity were more likely to receive the booster dose of COVID-19 vaccine〔OR (95%CI) =1.09 (1.01, 1.18), P<0.05〕. Compared with the older adults from the central region without chronic diseases, the older adults from the eastern region without chronic diseases were less likely to receive the booster dose of COVID-19 vaccine〔OR (95%CI) =0.44 (0.29, 0.68), P<0.05〕.

More attention should be paid to the elderly who are senior and with chronic diseases in the process of COVID-19 vaccination. The vaccination rate of the elderly should be further increased by strengthening the publicity of COVID-19 vaccine knowledge.

老年人是新型冠状病毒疫苗（简称新冠疫苗）接种的重点人群，接种新冠疫苗可有效降低其感染新型冠状病毒后发展为重症、危重症患者甚至死亡的风险。目前，我国老年人新冠疫苗接种率相对较低，且鲜少有研究者探讨老年人新冠疫苗接种行为。

分析我国老年人新冠疫苗接种行为及其影响因素，为提高老年人新冠疫苗接种率提供参考。

于2022年8月3—14日，采用分层随机抽样的方法，选取常州市武进区、郑州市中牟县、西宁市城中区和牡丹江市林口县1 323例60岁及以上老年人为研究对象，采用自设问卷对其进行调查。运用二元Logistic回归分析影响老年人接种第一剂新冠疫苗、完成新冠疫苗全程接种、接种新冠疫苗加强剂的因素。

96.60%（1 278/1 323）的老年人接种了第一剂新冠疫苗，91.76%（1 214/1 323）的老年人完成了新冠疫苗全程接种，79.67%（1 054/1 323）的老年人接种了新冠疫苗加强剂。二元Logistic回归分析结果显示，与年龄为60~64岁的老年人相比，年龄≥75岁的老年人接种第一剂新冠疫苗的可能性更小〔OR（95%CI）=0.27（0.11，0.62），P<0.05〕；与患有慢性病的老年人相比，未患有慢性病的老年人接种第一剂新冠疫苗的可能性更大〔OR（95%CI）=2.07（1.12，3.84），P<0.05〕；感知利益水平越高的老年人接种第一剂新冠疫苗的可能性越大〔OR（95%CI）=1.39（1.07，1.79），P<0.05〕。与年龄为60~64岁、保持规律体育锻炼的老年人相比，年龄≥75岁〔OR（95%CI）=0.34（0.19，0.59），P<0.05〕、未保持规律体育锻炼〔OR（95%CI）=0.64（0.42，0.96），P<0.05〕的老年人完成新冠疫苗全程接种的可能性更小；与患有慢性病的老年人相比，未患有慢性病的老年人完成新冠疫苗全程接种的可能性更大〔OR（95%CI）=1.59（1.05，2.40），P<0.05〕。与年龄为60~64岁、来自中部地区的老年人相比，年龄≥75岁〔OR（95%CI）=0.55（0.36，0.86），P<0.05〕、来自东部地区〔OR（95%CI）=0.47（0.34，0.64），P<0.05〕的老年人接种新冠疫苗加强剂的可能性更小；与患有慢性病的老年人相比，未患有慢性病的老年人接种新冠疫苗加强剂的可能性更大〔OR（95%CI）=1.54（1.15，2.06），P<0.05〕；感知严重性水平越高的老年人接种新冠疫苗加强剂的可能性越大〔OR（95%CI）=1.06（1.00，1.11），P<0.05〕。亚组分析结果显示，与年龄为60~64岁、来自中部地区的患有慢性病的老年人相比，年龄≥75岁〔OR（95%CI）=0.35（0.19，0.65），P<0.05〕、来自东部地区〔OR（95%CI）=0.49（0.29，0.83），P<0.05〕的患有慢性病的老年人接种新冠疫苗加强剂的可能性更小；感知严重性水平越高的患有慢性病的老年人接种新冠疫苗加强剂的可能性越大〔OR（95%CI）=1.09（1.01，1.18），P<0.05〕。与来自中部地区的未患有慢性病的老年人相比，来自东部地区的未患有慢性病的老年人接种新冠疫苗加强剂的可能性更小〔OR（95%CI）=0.44（0.29，0.68），P<0.05〕。

在开展老年人新冠疫苗接种工作的过程中，应重点关注高龄和患有慢性病的老年人。通过加强新冠疫苗知识的宣传，进一步提高老年人新冠疫苗接种率。