Changes in Attitudes and Beliefs Concerning Vaccination and Influenza Vaccines between the First and Second COVID-19 Pandemic Waves: A Longitudinal Study

Abstract

Perceptions of the risks of vaccine-preventable diseases and preventive behaviors change over time. The ongoing COVID-19 pandemic may have modified laypeople’s attitudes towards routine vaccinations. In this longitudinal study, we aimed to assess changes in attitudes and beliefs concerning (influenza) vaccines between the first and second COVID-19 pandemic waves. A total of 1979 participants completed both 2020 and 2021 surveys. After one year, more interviewees agreed that vaccines were fundamental and should be mandatory (77.3% vs. 75.0%). Analogously, willingness to undergo influenza vaccination increased (p < 0.001) from 44.1% to 48.6%. This increase was seen in subjects aged ≥35 years. Previous influenza vaccinations, receipt of a COVID-19 vaccine, positive attitudes towards (influenza) vaccination, male sex, and older age were the main correlates of willingness to receive the 2021/22 influenza vaccine. Totals of 12.6% and 11.8% had no intention to receive the next seasonal influenza and COVID-19 vaccines, respectively. Most respondents favored a hypothetical combined influenza/COVID-19 vaccine (73.7%) or influenza and COVID-19 vaccine co-administration (67.5%). In Italy, influenza and COVID-19 vaccination hesitancy and refusal are common. Effective public health strategies to pursue higher uptake of both vaccines are urgently needed.

Acceptance of COVID-19 and Influenza Vaccine Co-Administration: Insights from a Representative Italian Survey

“…Indeed, only 23% of adult Italians would willingly accept concomitant immunization, while 17% would absolutely not; the remaining majority (approximately 60%) may be dubbed as hesitant to some degree. The number of co-administration-hesitant individuals proved to be higher than that of the SIV-hesitant subjects recorded in our previous studies [11,18] on the acceptance of SIV alone. A similar tendency has been reported with regard to pediatric vaccinations: in Italy, vaccinehesitant individuals are less favorable toward using combined vaccines and vaccine coadministration [24].…”

“…Increasing age is usually associated with a higher vaccine acceptance [16,17,30,[33][34][35][36]. In our previous survey rounds [11,18], both SIV uptake and acceptance were higher in older individuals. By contrast, in this study an inverse age-acceptance relationship was observed: each 1-year increase in age was associated with a 1.1% decrease in the odds of accepting simultaneous vaccine administration.…”

“…Similarly, SIV uptake in previous seasons is associated with subsequent SIV receipt [34][35][36]. Moreover, COVID-19 vaccination status is also a strong correlate of 2021/2022 SIV receipt [11]. In California, a decreasing trend in intentions to receive both COVID-19 and SIV vaccines was observed once the first COVID-19 vaccines were available [37].…”

“…The co-administration of COVID-19 vaccine and 2021/2022 SIV may yield some potential benefits, including logistical advantages, cost reduction and the possibility to increase the uptake of both vaccines [10,11]. Preliminary data suggest that the concomitant administration of COVID-19 and SIV vaccines is a feasible option.…”

Effect of the 2020/21 season influenza vaccine on SARS-CoV-2 infection in a cohort of Italian healthcare workers

“…Acceptance of SIV and COVID-19 vaccines is interrelated. On the one hand, previous experience of SIV increases the likelihood of receiving COVID-19 vaccines; on the other hand, the uptake of SIV may increase as a consequence of the ongoing COVID-19 pandemic [45] , [46] . We believe that integrating messages regarding non-specific vaccine effects into a promotional communication mix could help to convince some hesitant HCWs, thereby increasing vaccine uptake.…”