Background: Public health strategies in Australia and Hong Kong recommend influenza and pneumococcal vaccination for adults’ ≥ 65 years who are particularly at risk of severe illness yet there are differences in uptake between countries.

Aim: This qualitative study was conducted in two parts. The first, previously reported, aimed to gain a better understanding of the perceptions and barriers to receiving seasonal influenza and pneumococcal vaccines among Australian and Hong Kong adults aged ≥ 65 years. This article addresses part two which compares the findings between the Australian and Hong Kong participants.

Methods: Overlapping themes developed from the analysis of the Australian and Hong Kong data were compared and key issues of difference and alignment between participants in both countries were identified.

Results: Vaccine uptake for the two diseases was found to be considerably lower in Hong Kong than in Australia. Common and divergent issues identified include the impact of different health systems, the promotion of vaccination by health professionals, beliefs about hospitals and clinics, traditional and alternative medicines, perceptions of risk and personal responsibility.

Conclusion: The importance of health systems that enable access to vaccines and promotion by health professionals are important factors in vaccine uptake. Certain health beliefs can pose barriers to receiving vaccinations.