Background
In the context of China’s aging population and low influenza vaccine coverage, this study applied the Behavioral and Social Drivers (BeSD) framework to investigate the willingness and determinants of influenza vaccination among adults aged?≥?60?years in Chongqing.

Research design and methods
We designed a cross-sectional survey targeting the community population and collected data on willingness toward demographic and influenza vaccination through questionnaires. Descriptive analysis, logistic regression analyses were used to summarize the data and identify the possible factors of vaccination willingness.

Results
Among 1617 participants, 46.9% (95%CI: 44.5-49.3) expressed willingness to receive influenza vaccines. Individuals aged?≥?80?years (aOR?=?1.51, 95%CI: 1.10-2.08) and having basic medical insurance for urban employees (aOR?=?2.21, 95%CI: 1.69-2.90) were more likely to receive influenza vaccination. Participants who lived in rural areas (aOR?=?0.38, 95%CI: 0.39-0.50) were more likely to experience vaccine hesitancy. Concerning the BeSD framework, concern of worsening health condition (74.43%) and concern of disrupted daily life (69.76%) were the primary and secondary concerns, whereas perceived high vaccine cost (54.95%) was identified as a major reason for hesitancy.

Conclusions
This study further highlighted that psychological determinants, thinking and feeling are the most influential of vaccine acceptance and hesitancy.