The need for targeted efforts to build trust and communicate the safety and convenience of coadministration to improve uptake among older adults is highlighted.
Abstract
Background
Health authorities recommend adults aged 65 years and older receive COVID-19 and influenza vaccines at the same visit to improve vaccine uptake in this high-risk group. However, it remains unclear how widely older adults have accepted this recommendation in practice.
Methods
Using data from the Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission, we examined coadministration uptake and factors associated with its acceptance among 2,860 community-dwelling Korean adults aged 65 years or older who received the 2023-2024 influenza vaccine. Verified vaccination and infection records from the Korea Disease Control and Prevention Agency were linked with survey responses on psychological antecedents of COVID-19 vaccination. Vaccination behavior was categorized as coadministration, separate visit vaccination, or influenza-only vaccination.
Results
Overall, 15.0% received both vaccines at the same visit, while 43.3% received them on separate days. Prior receipt of both vaccines was the strongest predictor of coadministration (OR, 2.59; 95% CI, 1.70-3.95). Higher confidence in COVID-19 vaccination (OR, 1.30; 1.12-1.50) and lower complacency (OR, 0.81; 0.73-0.91) were associated with coadministration uptake.
Conclusions
These findings highlight the need for targeted efforts to build trust and communicate the safety and convenience of coadministration to improve uptake among older adults.
Background/aim: Vaccines reduce morbidity and mortality caused by infectious diseases that threaten public health. Lifelong immunization programs are essential for the entire population. This study assessed adult vaccination uptake for influenza, pneumococcal, and coronavirus disease 2019 (COVID-19) vaccines in Türkiye and examined the barriers and factors influencing vaccination decisions.
Materials and methods: This cross-sectional survey was designed and conducted by the Immunization Working Group of the Turkish Society of Clinical Microbiology and Infectious Diseases. A 19-item questionnaire was administered to individuals aged 18 years or older to assess influenza, pneumococcal, and COVID-19 vaccination status. The questionnaire collected data on demographic characteristics, healthcare worker (HCW) status, chronic diseases, vaccination history, vaccine preferences, and reasons for nonvaccination.
Results: The influenza vaccination rate among all participants was 28%, with the highest rate observed among participants aged ≥65 years (49%). Multivariate analysis revealed that age ≥65 years, HCW status, and the presence of a chronic disease were independently associated with influenza vaccination (p < 0.001). Pneumococcal vaccination rates were higher among individuals with chronic diseases and those aged ≥65 years (p < 0.01). Among chronic diseases, the highest vaccination rate was observed in participants with coronary artery disease. The COVID-19 vaccination rate was 95%. The most common reasons for nonvaccination were the perception that influenza (39%) and pneumococcal (21%) vaccination was unnecessary, whereas unwillingness to be vaccinated (44%) and concerns about side effects (32%) predominated for COVID-19 vaccination.
Conclusions: Vaccination coverage remains low in Türkiye, even among high-risk groups. Although vaccination rates increased during the pandemic, greater public awareness and educational efforts are still needed.
Gamze Şanlıdağ İşbilen, S. Gençer, H. Pullukçu et al.· Turkish Journal of Medical S...· 0 citations
Seasonal Influenza and COVID-19 vaccination programmes are critical for reducing morbidity and mortality in older adults, yet uptake remains uneven across populations. We aimed to profile vaccination attitudes and examine predictors of COVID-19/influenza vaccination uptake among a UK participatory surveillance system - FluSurvey. We analysed FluSurvey data from participants aged [≥]65 years who were eligible for both vaccines in the 2023-2024 and 2024-2025 Autumn - Winter seasonal campaigns. Descriptive analyses examined self-reported attitudes to influenza vaccination. Logistic regression examined factors (age, sex, socioeconomic status, education, employment, transport, smoking and chronic conditions) associated with influenza and COVID-19 vaccination uptake in each season, adjusting for confounders. Belonging to a risk group and reducing risk of influenza were frequently reported motivations for influenza vaccination, while building natural immunity and concerns around safety and adverse effects were frequently reported barriers. Individuals vaccinated against COVID-19 were more likely to receive an influenza vaccination (aOR2023-2024=13.90 [9.28-21.17]; aOR2024-2025=8.54 [5.82-12.60]), and vice-versa (aOR2023-2024=13.91 [9.30-21.19]; aOR2024-2025=8.52 [5.81-12.58]). Lower educational attainment was associated with lower odds of COVID-19 vaccination (aOR2023-2024=0.59 [0.45-0.78], aOR2024-2025: 0.56 [0.39-0.79]). Other results were weaker or demonstrated variation by season. Our findings highlight recent attitudes and barriers to influenza and COVID-19 vaccination among the FluSurvey cohort, which may inform approaches to improve vaccination coverage in the population.
L. Adams, C. Watson, R. E. Green et al.· medRxiv· 0 citations
Targeted communication, such as risk-stacking to improve risk-awareness, harmonized eligibility criteria, and co-administration, may help overcome remaining vaccination barriers in high-risk individuals.
Lucas Grape, Wilma Persson, Adam Sergejev et al.· Human Vaccines & Immunothera...· 0 citations
Targeted communication, such as risk-stacking to improve risk-awareness, harmonized eligibility criteria, and co-administration, may help overcome remaining vaccination barriers in high-risk individuals.
Lucas Grape, Wilma Persson, Adam Sergejev et al.· 0 citations
Despite the documented safety and efficacy of the COVID-19 vaccination, parental pediatric vaccine hesitancy is common. Little is known about the concerns and beliefs held by caregivers that impact COVID vaccination decision-making on behalf of their minor children, as underlying attitudes toward pediatric COVID-19 vaccination have not been well described. Unvaccinated children and their caregivers underwent antibody testing and completed an electronic survey at four clinic-based practices in Northern and Central New Jersey from August 2022 to June 2023. Caregivers were grouped into four attitudinal classes based on how safe, effective, useful, and necessary they believed COVID-19 vaccination were. Caregivers in the lowest vaccine acceptance classes (1 and 2) were significantly less likely to plan to vaccinate their children compared to those in the higher classes (3 and 4) (8.9% and 5.6% vs. 30.4% and 61%). Those in Class 2 were significantly less likely to have at least one adult household member fully vaccinated or boosted against COVID-19 than those in higher classes and marginally more likely to be from households where at least one adult had been diagnosed with COVID-19 in the past year than those in Class 3 (52% vs. 40%). The majority of caregivers viewed their pediatrician as a trusted source of information (89%). Caregiver attitudes toward vaccination are associated with household vaccination status and family COVID-19 infection history. Pediatricians play an important role in aiding vaccine uptake among children. Educational efforts should target differing caregiver profiles to address vaccine hesitancy and make future pediatric vaccine programming more successful.
Božena J Katić, Aspasia Katragkou, Uzma N. Hasan et al.· Behavioral Medicine· 0 citations
BACKGROUND
Influenza vaccination coverage in France remains suboptimal, with variability across population groups. We assessed demographic and behavioral determinants of influenza vaccination in the post-COVID-19 period among a primary care population in the Haute-Vienne department (Nouvelle-Aquitaine, France).
METHODS
We conducted a cross-sectional survey using an anonymous, self-administered questionnaire distributed to adults attending five general-practice sites between May and July 2023. The primary outcome was receipt of the 2022-2023 influenza vaccine. Candidate determinants included age, sex, municipality size, socio-professional category, eligibility criteria (age ≥ 65 years, healthcare-worker status, chronic conditions, or pregnancy), prior influenza vaccination, number of COVID-19 vaccine doses received, and self-reported history of influenza infection. Associations were examined using chi-square tests, Cochran-Armitage trend tests, and univariate logistic regression. Two multivariable logistic regression models were then constructed: a demographic model including age, sex, municipality size, socio-professional category, and the presence of any comorbidity or pregnancy, and a behavioral model including prior influenza vaccination and COVID-19 vaccination status (≥ 3 doses vs. ≤ 2 doses). Adjusted results were expressed as adjusted odds ratios (aOR) with 95% confidence intervals (95% CI).
RESULTS
Among the 800 questionnaires distributed, 432 were returned (participation rate: 54%). Overall, 75.9% of participants met at least one eligibility criterion for influenza vaccination. Influenza vaccination coverage for the 2022-2023 season was 58.3% and differed by municipality size (38.8% in areas with fewer than 5,000 inhabitants; 59.2% in those with 5,000-10,000; and 64.3% in those with more than 10,000, p = 0.0003) and increased with the regularity of prior influenza vaccination (6.7% among never vaccinated, 55.9% among occasional, and 96.6% among annually vaccinated, p < 0.0001). Coverage was also associated with the number of COVID-19 vaccine doses received (p < 0.0001). In the demographic model, age ≥ 65 years was associated with higher vaccination uptake (aOR 8.55, 95% CI 1.88-61.73, p = 0.012), whereas other demographic variables were not independently associated with vaccination uptake. In the behavioral model, prior influenza vaccination was strongly associated with vaccination uptake (aOR 16.20, 95% CI 7.21-36.41 for occasional vs. never and aOR 331.21, 95% CI 122.57-894.99 for annual vs. never; both p < 0.001). Receipt of ≥ 3 COVID-19 vaccine doses was also independently associated with vaccination uptake (aOR 2.64, 95% CI 1.01-6.89, p = 0.047).
CONCLUSIONS
In this primary care survey, influenza vaccination during the 2022-2023 season was primarily associated with prior influenza vaccination history, suggesting persistence of vaccination practices over time. Age ≥ 65 years and receipt of ≥ 3 COVID-19 vaccine doses were also independently associated with vaccination uptake, although to a lesser extent. Targeted strategies that reinforce continuity (annual reminders, vaccination offers during routine visits, and co-administration options) and encourage initiation among previously unvaccinated adults could help improve coverage.
TRIAL REGISTRATION
Not applicable.
S. Mafi, A. Billo, M. Durieux et al.· BMC Public Health· 0 citations
