Influenza Vaccination in the Time of COVID-19: A National U.S. Survey of Adults

Sturm, Lynne; Kasting, Monica L.; Head, Katharine J.; Hartsock, Jane A.; Zimet, Gregory D.

Introduction Decisions about influenza vaccination for fall-winter 2020 were made against the backdrop of the COVID-19 pandemic. During May 2020, the authors examined intended vaccination in the next 12 months in relationship to demographic variables, healthcare attitudes, and personal COVID-19 experiences for two samples of adults--those who did not receive influenza vaccine during the prior 12 months, and those who did. Methods In May 2020, a cross-sectional online survey was conducted with a national US sample. Participants reported prior influenza vaccination (yes/no during prior 12 months) and anticipated vaccination (yes/no during next 12 months). Covariates included demographic characteristics (e.g., gender, race-ethnicity, political ideology), general beliefs (e.g., benefits of vaccines, altruistic attitudes), and COVID-19 health beliefs and experiences (COVID-19 worry and severity, perception of COVID-19 as a community threat, knowing someone with COVID-19). For each group, hierarchical multivariable logistic regression was conducted with intent to vaccinate as the outcome. Results Among participants (n=3,502), 47% did not receive influenza vaccine in the prior 12 months and 53% had; 25.5% of non-vaccinators and 91.9% of vaccinators intended future vaccination. For non-vaccinators, odds of intending vaccination was associated with race/ethnicity (Hispanics were more likely to intend than white-NH; AOR=1.74; 95%CI=1.23-2.4), greater perceived benefits of vaccination (AOR=2.19;95%CI=1.88-2.54), and perception of COVID-19 as a community threat (AOR=1.91;95%CI=1.49-2.45). For vaccinators, odds of intending vaccination was associated with age (AOR=1.04;95%CI=1.03-1.05), race/ethnicity (Black-NH and Other-NH were less likely to intend than white-NH, AOR=.60;95%CI=.36-.999; and AOR=.45;95%CI=.24-.84, respectively), greater perceived benefits of vaccination (AOR=1.88;95%CI=1.45-2.45) and greater perception of collective benefits of vaccines (AOR=1.48;95%CI=1.15-1.90). Conclusions The COVID-19 pandemic may have served as a cue to action for influenza vaccination intention among some prior non-vaccinators whereas intention among prior vaccinators is more related to positive attitudes toward vaccination.