PCV21 Acceptance in Adults ≥50 Years and Caregivers in Panama

Intergenerational Determinants of PCV21 Acceptance in Adults ≥50 Years in Panama: Knowledge, Attitudes, and Practices in Older Adults and Their Caregivers

This study will look at what adults age 50 years and older in Panama know, think, and do about pneumococcal vaccination, including the 21-valent pneumococcal conjugate vaccine (PCV21). Pneumococcal disease can cause pneumonia and other serious infections, and older adults may be at higher risk of severe illness. The study will help researchers understand what supports or prevents vaccine acceptance in this population.

The study will include two groups. Group A will include adults 50 to 64 years of age. Group B will include adults 65 years of age or older and a caregiver chosen by the older adult. A caregiver may be a family member or another person who regularly helps or supports the older adult. Researchers will study whether the caregiver's views about vaccines are related to the older adult's intention to receive PCV21.

Participants will complete a one-time survey about pneumococcal disease, vaccines, vaccination history, health information sources, trust in vaccines, barriers to vaccination, and factors that may make vaccination easier. Surveys may be completed on paper with help from study staff or digitally using a tablet or smartphone. The survey is expected to take about 10 to 15 minutes. For older adults and caregivers in Group B, each person will complete their own survey separately so that one person's answers do not influence the other's answers.

This is an observational study. No vaccine, medicine, or study product will be given as part of the study. Taking part involves answering survey questions only. The study will recruit participants from public and private health care facilities, including at least one rural or semi-urban site, to better reflect the diversity of adults in Panama.

The information from this study may help health care providers, public health teams, and community organizations design clearer and more useful communication about pneumococcal vaccination for adults and their caregivers. The results may also support future recommendations for adult vaccination programs in Panama and similar settings.

Inclusion Criteria Older adults - all cohorts

• Age 50 years or older.
• Cohort A: 50-64 years.
• Cohort B: 65 years or older.
• Resident of Panama, including urban, semi-urban, or rural areas.
• Has access to medical care through the public or private health care system.
• Able and willing to provide signed informed consent.

Caregivers - Cohort B only

• Age 18 years or older.
• Identified as the caregiver of a Cohort B older adult.
• Has regular cohabitation or contact with the older adult, defined as at least once per week.
• Able and willing to provide signed informed consent.

Exclusion Criteria

Older adults - all cohorts

• Cognitive impairment that prevents the participant from providing informed consent.
• Does not speak Spanish and no interpreter is available.

Caregivers - Cohort B only

- Professional caregiver with no personal relationship to the older adult.