Effect of COVID-19 Pandemic on Influenza Vaccination Intention: A Meta-Analysis and Systematic Review

Abstract

Poorer outcomes have been reported with COVID-19 and influenza coinfections. As the COVID-19 pandemic rages on, protection against influenza by vaccination is becoming increasingly important. This study examines how COVID-19 has influenced influenza vaccination intentions from a global perspective. A literature search was conducted on Embase, PubMed, and CNKI from 1 January 2019 to 31 December 2021 for articles reporting rates of influenza vaccination pre-COVID-19 (19/20 season), and intention and/or uptake of influenza vaccination post-COVID-19 (20/21 season). The changes in vaccination intention and reasons for changes were reported. Subgroup analyses were performed by region, gender, age, and occupation. Newcastle Ottawa Scale was used for quality assessment of the articles. Twenty-seven studies with 39,193 participants were included. Among 22 studies reporting intention to vaccinate in 20/21, there was increased intention to vaccinate (RR 1.50, 95% CI 1.32–1.69, p < 0.001) regardless of age, gender, and occupation. The remaining five studies reporting vaccination intention and uptake in 20/21 showed a similar increase (RR 1.68, 95%CI 1.20–2.36). Important determinants include historical vaccine acceptance, and perception of influenza severity and vaccine safety. The COVID-19 pandemic has increased intention to vaccinate against influenza internationally. The pandemic could be a window of opportunity to promote influenza vaccination and decrease vaccine hesitancy.

COVID-19 and Influenza Vaccination Campaign in a Research and University Hospital in Milan, Italy

“…Similar results have been reported by other Italian [ 33 , 34 , 35 ] and international studies [ 36 , 37 , 38 ]. Therefore, it is possible to hypothesize that the SARS-CoV-2 pandemic could have played a significant role in increasing awareness on the importance of vaccination in general and specifically of flu vaccination, thus contributing to increase the flu VCRs, even among HCWs [ 39 , 40 , 41 , 42 , 43 ].…”

“…In the 2021–2022 influenza vaccination campaign for HCWs in Fondazione, a VCR > 50% (52.0%) was reached for the first time, confirming the positive trend started in the 2020–2021 campaign [ 25 ]. A great contribution by the COVID-19 pandemic in renewing HCWs’ awareness towards the need for protection against respiratory infections, primarily influenza, is highly probable and widely highlighted in the literature [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ].…”

Influenza Vaccination Uptake and Hesitancy among Healthcare Workers in Early 2021 at the Start of the COVID-19 Vaccine Rollout in Cape Town, South Africa

“…Previous findings from Saudi Arabia [ 32 ] were in accordance with another study carried out in Lebanon during the COVID-19 pandemic in 2020 on 560 Lebanese HCWs, who had the belief that good knowledge of vaccination, having previously received the influenza vaccine, perception of flu vaccine benefits in decreasing hospitalization, and prevention of influenza–COVID-19 co-infection had a positive influence on attitudes towards influenza vaccination [ 59 ]. Kong et al conducted a meta-analysis and systematic review of 27 studies from 1 January 2019 to 31 December 2021 with the aim of evaluating the “effect of COVID-19 pandemic on influenza vaccination intention” [ 20 ]. Their findings showed that studies reported increased intention to vaccinate in 2020/21, regardless of demographics.…”

“…Moreover, there is no clarity on the association between influenza vaccination and COVID-19 infection. Kong and colleagues conducted a systematic review of 27 studies from 1 January 2019 to 31 December 2021 with the aim of evaluating the “effect of COVID-19 pandemic on influenza vaccination intention” [ 20 ]. Their findings from a systematic synthesis of 27 studies on the effects of the COVID-19 pandemic on influenza showed an increase in intention to vaccinate in 2020/2021, regardless of the participants’ demographics [ 20 ].…”

“…Kong and colleagues conducted a systematic review of 27 studies from 1 January 2019 to 31 December 2021 with the aim of evaluating the “effect of COVID-19 pandemic on influenza vaccination intention” [ 20 ]. Their findings from a systematic synthesis of 27 studies on the effects of the COVID-19 pandemic on influenza showed an increase in intention to vaccinate in 2020/2021, regardless of the participants’ demographics [ 20 ]. Thus, despite inconsistent results, this suggests that the COVID-19 pandemic increased the intention to vaccinate against influenza in other parts of the world.…”