Predictors of seasonal influenza and COVID-19 vaccination coverage among adults in Tennessee during the COVID-19 pandemic.

The COVID-19 pandemic has convoluted hesitancy toward vaccines, including the seasonal influenza (flu) vaccine. Because of COVID-19, the flu season has become more complicated; therefore, it is important to understand all the factors influencing the uptake of these vaccines to inform intervention targets. This article assesses factors related to the uptake of influenza and COVID-19 vaccines among adults in Tennessee. A cross-sectional, secondary data analysis of 1,400 adults was conducted in Tennessee. The adult sample came from two data sources: Data source 1 completed a baseline survey from January to March 2022, and data source 2 was completed from May to August 2022. Data on vaccine attitudes, facilitators and barriers, and communication needs were collected via random digit dial by Scientific Telephone Samples (STS). Two multivariable logistic regression models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to predict sociodemographic and overall vaccine-related factors associated with receipt or non-receipt (referent) of COVID-19 and influenza vaccines. Approximately 78% of the adult sample had received the COVID-19 vaccination. A significant positive association for COVID-19 vaccine uptake was seen among those who were older (aged 50-65) (aOR = 1.9; 95% CI: 1.2-3.2), Black (aOR = 2.0; 95% CI:1.3-2.8), and had a college education and higher (aOR = 2.3; 95% CI: 1.5-3.6). However, there was a significant negative association for persons reporting they were extremely religious (aOR = 0.5; 95% CI:0.3-0.9). Over 56% of the adult sample had received the influenza vaccination this season. Those who had a higher annual household income ($80,000+) (aOR = 1.9; 95% CI: 1.3-2.6) and had health insurance (aOR = 2.6; 95% CI: 1.4-4.8) had a significant positive association with influenza vaccine receipt. However, those who were employed part-time or were unemployed had a significant negative association for influenza vaccine receipt (aOR = 0.7; 95% CI: 0.5-0.9). Both COVID-19 and influenza vaccine receipt had strongly significant positive trends with increasing belief in effectiveness and trust (p < 0.0001) and strongly significant negative trends with higher levels of overall vaccine hesitancy (p < 0.0001). Strategies to increase COVID-19 and influenza vaccination should be age-specific, focus on increasing geographical and financial access, and offer tailored messages to address concerns about these vaccines.

Cunningham-Erves J ，George W ，Sanderson M ，Stewart E ，Jin SW ，Davis J ，Brandt HM ... -  《Frontiers in Public Health》

Receipt of COVID-19 and seasonal influenza vaccines in California (USA) during the 2021-2022 influenza season.

Despite lower circulation of influenza virus throughout 2020-2022 during the COVID-19 pandemic, seasonal influenza vaccination has remained a primary tool to reduce influenza-associated illness and death. The relationship between the decision to receive a COVID-19 vaccine and/or an influenza vaccine is not well understood. We assessed predictors of receipt of 2021-2022 influenza vaccine in a secondary analysis of data from a case-control study enrolling individuals who received SARS-CoV-2 testing. We used mixed effects logistic regression to estimate factors associated with receipt of seasonal influenza vaccine. We also constructed multinomial adjusted marginal probability models of being vaccinated for COVID-19 only, seasonal influenza only, or both as compared with receipt of neither vaccination. Among 1261 eligible participants recruited between 22 October 2021-22 June 2022, 43% (545) were vaccinated with both seasonal influenza vaccine and >1 dose of a COVID-19 vaccine, 34% (426) received >1 dose of a COVID-19 vaccine only, 4% (49) received seasonal influenza vaccine only, and 19% (241) received neither vaccine. Receipt of >1 COVID-19 vaccine dose was associated with seasonal influenza vaccination (adjusted odds ratio [aOR]: 3.72; 95% confidence interval [CI]: 2.15-6.43); this association was stronger among participants receiving >1 COVID-19 booster dose (aOR = 16.50 [10.10-26.97]). Compared with participants testing negative for SARS- CoV-2 infection, participants testing positive had lower odds of receipt of 2021-2022 seasonal influenza vaccine (aOR = 0.64 [0.50-0.82]). Recipients of a COVID-19 vaccine were more likely to receive seasonal influenza vaccine during the 2021-2022 season. Factors associated with individuals' likelihood of receiving COVID-19 and seasonal influenza vaccines will be important to account for in future studies of vaccine effectiveness against both conditions. Participants who tested positive for SARS-CoV-2 in our sample were less likely to have received seasonal influenza vaccine, suggesting an opportunity to offer influenza vaccination before or after a COVID-19 diagnosis.

Andrejko KL ，Myers JF ，Openshaw J ，Fukui N ，Li S ，Watt JP ，Murray EL ，Hoover C ，Lewnard JA ，Jain S ，Pry JM ，California COVID-19 Case-Control Study Team ... -  《-》

Vaccination against influenza among Lebanese health care workers in the era of coronavirus disease 2019.

Health-care workers (HCWs) are at a higher occupational risk of contracting and transmitting influenza. Annual vaccination is an essential tool to prevent seasonal influenza infection. However, HCWs vaccine hesitancy remains a leading global health threat. This study aims to evaluate the flu vaccination coverage rates among Lebanese HCWs and to assess their knowledge, attitudes, practices, perceived barriers, and benefits toward the flu vaccine during the COVID-19 pandemic. In addition, we sought to identify the factors associated with flu vaccine uptake. A cross-sectional study using an online survey was conducted in Lebanon among HCWs between 14 and 28 October 2020. Multivariable logistic regression was carried out to identify the factors associated with influenza vaccine uptake. A total of 560 HCWs participated in the survey of whom 72.9% were females, and 53.9% were aged between 30-49 years. Regarding Flu vaccination uptake, the rate has risen from 32.1% in 2019-2020 to 80.2% in 2020-2021 flu season. The majority of HCWs had a good knowledge level and a positive attitude toward flu vaccination. Regarding their practices, less than 50% of HCW were currently promoting the importance of getting the flu vaccine. The majority (83.3%) ranked the availability of a sufficient quantity of vaccines as the most significant barrier to flu vaccination. The main perceived flu vaccination benefits were enhancing patient safety, minimizing the viral reservoir in the population, decreasing hospital admission, and avoiding influenza and COVID-19 co-infection. The odds of influenza vaccine uptake was lower in unmarried compared to married HCWs (OR = 0.527, CI (0.284-0.978). However, HCWs having received the influenza vaccine in the previous season (OR = 6.812, CI (3.045-15.239)), those with good knowledge level (OR = 3.305, CI (1.155-9.457)), low perceived barriers (OR = 4.130, CI (1.827-9.334)) and high perceived level of the benefits (OR = 6.264, CI (2.919-13.442)) of the flu vaccination were found more prone to get the flu vaccine. Flu vaccination uptake has increased among HCWs during the 2020-2021 flu season compared with the previous one. Continuing education as well as ensuring free, equitable, and convenient access to vaccination are still required to increase the annual flu vaccination uptake among HCWs.

Youssef D ，Berry A ，Youssef J ，Abou-Abbas L ... -  《BMC PUBLIC HEALTH》

Association between risk perception and influenza vaccine hesitancy for children among reproductive women in China during the COVID-19 pandemic: a national online survey.

In China, the national prevalence of parental influenza vaccine hesitancy (IVH) during the pandemic of coronavirus disease 2019 (COVID-19), and the association between risk perception and parental IVH are still unclear. We aimed to explore the association between risk perception and IVH for children among reproductive women in China, a poorly studied area. From December 14, 2020, to January 31, 2021, we conducted a national anonymous online survey on IVH for children among reproductive women in China. We assessed risk perception including perceived susceptibility, severity, barriers, and benefits using the Health Belief Model and then classified each variable into three groups based on tertiles. Logistic regression models were used to calculate the adjusted odds ratio (aOR) of risk perception related to vaccine hesitancy after controlling for sociodemographic characteristics, health status, and knowledge of influenza, among other factors. Additionally, subgroup analysis was performed. Among 3,011 reproductive women, 9.13% reported IVH. In multivariable models, vaccine hesitancy was associated with low perceived susceptibility (aOR = 2.55, 95% CI: 1.79-3.65), higher perceived barriers (moderate: aOR = 1.47, 95% CI: 1.04-2.08; high: aOR = 2.20, 95% CI: 1.47-3.30), and low perceived benefit (moderate: aOR = 1.40, 95% CI: 1.03-1.92; low: aOR = 2.10, 95% CI: 1.43-3.07). Subgroup analysis showed that vaccine hesitancy was more likely to occur among women with high perceived barriers aged < 30 years compared with those older than 30 years (P for difference = 0.041) and among women with moderate perceived benefit who had never conceived compared with those had a history of pregnancy (P for difference = 0.048). Nearly one in 10 reproductive women was hesitant about influenza vaccination for their children during the COVID-19 pandemic. To mitigate vaccine hesitancy, our findings highlight a need for tailored public health measures to increase perceived disease susceptibility and vaccine benefit and decrease perceived barriers. Furthermore, the effect of high perceived barriers and moderate perceived benefit on vaccine hesitancy was higher among younger women and women who had never conceived.

Du M ，Tao L ，Liu J 《BMC PUBLIC HEALTH》

Changes of influenza vaccination rate and associated influencing factors after the COVID-19 pandemic in Shanghai, China.

Sun G ，Zhang L ，Qiu Y ，Jia Y ，Wang Y ，Xu H ，Zhang A ，Hao L ，Zhu W ，Ye C ... -  《-》