The Impact of the COVID-19 Pandemic on Influenza Vaccination Attitudes and Actions in Spain’s Adult Population

Abstract

Seasonal influenza is an acute respiratory infection caused by the influenza virus which constitutes a significant public health issue associated with high morbidity and mortality. The aim of this study was to investigate changes in attitudes, perceptions, and practices regarding influenza vaccination in the Spanish adult population during the COVID-19 pandemic, as well as their vaccination intentions, with special attention paid to those over 65 years old and in high-risk groups. To this end, a cross-sectional study was conducted through 2219 telephone interviews, and the results were compared with results obtained a year earlier. Regarding the reasons for deciding to get vaccinated in the 2022/23 season, a significant increase was observed in vaccine confidence (36.7% vs. 42.8%), social responsibility (32.5% vs. 43.8%), and in awareness of the importance of vaccination due to COVID-19 (21.7% vs. 25.4%). Advanced age (OR 2.8, 95% CI 2.0–3.9), belonging to high-risk groups (OR 2.7, 95% CI 2.0–3.7), and prior vaccination (OR 25.3, 95% CI 19.5–32.7) emerged as significant predictors for the intent to receive the influenza vaccine in the 2022/23 season. Continuously observing shifts in perceptions and behaviors related to influenza immunization is crucial to pinpoint factors that may influence the willingness to receive the vaccine and, in this way, design public health strategies that achieve a greater acceptance of it.

Exploring Perceptions and Practices Regarding Adult Vaccination against Seasonal Influenza, Tetanus, Pneumococcal Disease, Herpes Zoster and COVID-19: A Mixed-Methods Study in Greece

“…Delving into participants’ arguments about abstinence, thematic content analysis revealed themes that fit the proposed “3Cs” (confidence, convenience, complacency) and “5Cs” (confidence, convenience, complacency, calculation, collective responsibility) models exploring vaccine hesitancy [ 4 , 43 ]: disbelief in effectiveness, fear of side effects, mistrust in institutions and policy practices (“confidence”), low susceptibility to disease (“complacency”), negligence (“convenience”), absence of health professionals’ recommendation and insufficient information (“calculation”). In line with previous studies, doubting the effectiveness of vaccines acts as a major deterrent in curbing immunization efforts [ 34 , 35 , 44 , 45 , 46 , 47 , 48 ], as is participants’ belief in good health and thus low perceived risk of vaccine-preventable diseases [ 34 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ]. Lack of advice, endorsement and guidance by health professionals reduces vaccine uptake [ 35 , 41 , 48 , 50 , 51 , 52 ], as is insufficient information about preventable diseases and the respective vaccines [ 46 , 47 , 51 , 52 ].…”

“…In line with previous studies, doubting the effectiveness of vaccines acts as a major deterrent in curbing immunization efforts [ 34 , 35 , 44 , 45 , 46 , 47 , 48 ], as is participants’ belief in good health and thus low perceived risk of vaccine-preventable diseases [ 34 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ]. Lack of advice, endorsement and guidance by health professionals reduces vaccine uptake [ 35 , 41 , 48 , 50 , 51 , 52 ], as is insufficient information about preventable diseases and the respective vaccines [ 46 , 47 , 51 , 52 ]. Our participants highlighted negligence as the root of no uptake and committed to prompt immunization, an argument also expressed in previous studies [ 41 , 46 ].…”

“…Doctors, and especially family physicians, were the primary source of information for all vaccines, influencing participants’ views on immunization and vaccination uptake, followed by pharmacists, reiterating findings of previous Greek, Dutch and Spanish studies [ 20 , 33 , 34 , 35 ]. Recent US surveys showcased the public’s trust in doctors, especially primary care practitioners, as a source of reliable information regarding vaccines [ 36 , 37 ].…”

“…Going forward, utilizing scales that go beyond trust and confidence, such as the ATAVAC scale, will be crucial in quantitatively examining vaccine hesitancy and its determinants across different populations. Doctors, and especially family physicians, were the primary source of information for all vaccines, influencing participants' views on immunization and vaccination up-take, followed by pharmacists, reiterating findings of previous Greek, Dutch and Spanish studies [20,[33][34][35]. Recent US surveys showcased the public's trust in doctors, especially primary care practitioners, as a source of reliable information regarding vaccines [36,37].…”

Impact of COVID-19 on Influenza and Pneumococcal Vaccination of Psoriatic Patients in Germany: Results from Vac-Pso

“…Conclusively, we found that patients who were willing to get vaccinated against COVID-19 were also more likely to be vaccinated against influenza and pneumococci. The impact of the pandemic on individual perceptions increasing vaccination awareness and uptake has recently been reported by others [ 21 , 22 , 23 , 24 ].…”