Influenza Vaccination During COVID-19 in a Rural Community: A Cross-sectional Survey

Abstract

Vaccination behavior is an informative metric for assessing flu seasons and is especially important to understand for the 2020–2021 flu season, which coincided with the COVID-19 pandemic. This study aimed to estimate flu vaccine behavior and assess vaccine perceptions during the pandemic season. Using a cross-sectional descriptive study design, we conducted an online survey to assess vaccination behavior and perceptions of both COVID-19 and the flu. Patients were identified as recently seen by providers in an academic internal medicine practice (n = 827) and surveys were distributed as messages in the Epic electronic medical record system. We found that 88.3% of respondents (188/206) had received their flu vaccination for the season at the time of their survey response in December 2020–February 2021. Of those that had not yet received the flu vaccine, only 13.6% indicated they planned on getting one. 12.5% of respondents said they had changed their flu vaccine plans due to the COVID-19 pandemic. Looking at differences from past season’s behavior, more individuals switched to getting the flu vaccine than those that switched to not getting the vaccine this season. The most frequently cited reasons for not receiving the flu vaccination were concerns about side effects and not being in a priority group. Changes in flu vaccination behavior from previous seasons represent a net positive in the direction of vaccine acceptance. Barriers to vaccination were identified and results from this study provide more information on vaccine perceptions, beliefs, and behavior, which can benefit future vaccination programs.

A retrospective cross-sectional analysis of community perceptions of flu and COVID-19 vaccines at Turtle Creek Primary Care Center

“…Vaccine uptake information showed that, although this study was conducted prior to the 2021 flu season, only ~44% of study participants showed predictive flu vaccine acceptance (gets flu vaccine all or most years). This differs from vaccine data gathered in a Central Pennsylvania cohort, which reported a high 88% flu vaccine acceptance rate-highlighting the stark differences that can exist in vaccine uptakes between various Pennsylvania communities and the need for individually assessing smaller local geographical areas (13). Only 54% of participants in the Turtle Creek community had received the COVID-19 vaccine; like in many U.S. communities, this falls short of the national vaccine acceptance rate considered sufficient for herd immunity (described as either >60% or as high as 90% in various studies) (14).…”

“…Three separate studies of vaccine hesitancy were conducted in nearby Central Pennsylvania, though all reported significant lack of diversity among sociodemographic groups. Study populations were comprised of 92%-97% non-Hispanic white adults, with the majority having attained high income and educational levels (11)(12)(13). In our study demographic, majority of participants identified as Black or African American (53%), women (81%), having finished high school and/or some post-graduate work but not college (65%), and in the 25-64 age range (78%), largely representative of known Turtle Creek community demographics (7).…”

The Influence of COVID-19 on Influenza and Respiratory Syncytial Virus Activities

“…Flu vaccine acceptance behavior is known to be influenced by COVID-19. A UK-based national survey reported that the pandemic had motivated unvaccinated people to accept the flu vaccine [ 30 ], while another survey from Pennsylvania, USA, described net favorable changes in flu vaccine acceptance behaviors since the COVID-19 outbreak [ 14 ]. However, when the data from the CDC were analyzed, we found an unchanged flu vaccine acceptance rate since the pandemic outbreak.…”

“…Thus, a US political map with categorical highlights of individual states based on recent flu activity would perhaps be helpful to visualize the variation across the country. This variation in flu activity might be influenced by factors such as nonpharmaceutical interventions [ 12 , 13 ], while flu vaccine acceptance rates could also be another contributor [ 14 ].…”

Public Interest in Distribution and Determinants of Influenza and Pneumonia Vaccination during the COVID-19 Pandemic: An Infodemiology and Cross-Sectional Study from China

“…This finding is in some agreement with other international studies. Domnich et al [20] found that about 20.4% of the Italian adults would not receive the 2020/21 flu vaccine if no COVID-19 pandemic occurred, and Marcus, R.E [39] found that 12.5% of adults in a rural American community changed their flu vaccination plan due to COVID-19. Perceptions of high susceptibility to COVID-19 were also positively associated with pneumonia vaccination uptake in our survey.…”