Mental health problems have become a major public health problem worldwide and are more common among middle-aged and elderly people in China. Research on the effect of education on depression is limited, and whether the relationship between education and depression changes over the life course remains unclear. This study was based on the cross-sectional data of 15,767 middle-aged and elderly individuals in the 2018 tracking survey (Wave 4) of the China Health and Retirement Longitudinal Study (CHARLS) database. Multiple linear regression and bootstrap methods were developed to detect the mediating effect of education on depression. In all samples or different age groups, education was significantly positively associated with depression. Three mediators (economic level, health-related lifestyle, and cognitive level) were significantly positively associated with depression, and cognitive level had a greater effect on depression than economic level and health-related lifestyle. The total, direct, and indirect effects of the whole samples and elderly samples were significant; however, the direct effect of the middle-aged samples was insignificant, and the total and indirect effects of the three mediating pathways were all significant, that is, economic level, health-related lifestyle, and cognitive level should produce complete mediation. The multiple linear regression and bootstrap methods could successfully detect the mediating effect of education on depression. On the basis of the education, economic level, health-related lifestyle, cognitive level, and depression of middle-aged and elderly people, we established and compared the total, direct, and mediating effects of education on depression under the life course. The mediating variables should be further increased, and the measurement methods of depression should be developed to improve the credibility of the research results.

Objectives: This study examines the recommendation behaviors and influencing factors for the 13-valent Pneumococcal Conjugate Vaccine (PCV13) among 3579 Chinese healthcare workers (HCWs), including 1775 pediatric care providers (Peds-PCPs) and 1804 primary care providers (PCPs). Data were collected from May to July 2023 through a national cross-sectional survey using a structured questionnaire, distributed across hospitals providing pediatric services in five provincial-level administrative divisions. Methods: The sociodemographic data, vaccine knowledge, and recommendation practices were analyzed using Pearson’s chi-square test, Wilcoxson rank-sum test, and multivariate logistic regression. Results show that while PCPs are more likely to recommend PCV13, vaccine hesitancy persists among Peds-PCPs. Logistic regression revealed that higher influenza vaccination intention, salary, vaccine consultation frequency, familiarity with immunization, work ethic, and flexible schedules positively impacted HCWs’ recommendation behavior. Results: Factors influencing Peds-PCPs’ recommendations include vaccine training (OR: 1.470, CI: 1.049–2.509), safety recognition (OR: 1.986, CI: 1.163–3.391), concern over rejection (OR = 1.274, CI: 1.076–1.508) and vaccine cost (OR = 1.203, CI: 1.023–1.414). For PCPs, influencing factors were the perceived susceptibility of children to pneumonia (OR = 2.185, CI: 1.074–4.445), acceptance of herd immunity (OR: 1.717, CI: 1.101–2.677), and belief that parents with better family conditions are more likely to accept vaccine recommendations (OR = 1.229, CI: 1.024–1.477). Conclusion: This survey underscores the need for tailored interventions to address differing perceptions and enhance confidence in the safety and efficacy of vaccines among HCWs, particularly Peds-PCPs.