The Impact of the COVID-19 Pandemic on the Uptake of Influenza Vaccine: UK-Wide Observational Study

  1. Patrik Bachtiger
  2. Alexander Adamson
  3. Ji-Jian Chow
  4. Rupa Sisodia
  5. Jennifer K Quint
  6. Nicholas S Peters

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Abstract

In the face of the COVID-19 pandemic, the UK National Health Service (NHS) extended eligibility for influenza vaccination this season to approximately 32.4 million people (48.8% of the population). Knowing the intended uptake of the vaccine will inform supply and public health messaging to maximize vaccination.

Objective

The objective of this study was to measure the impact of the COVID-19 pandemic on the acceptance of influenza vaccination in the 2020-2021 season, specifically focusing on people who were previously eligible but routinely declined vaccination and newly eligible people.

Methods

Intention to receive the influenza vaccine in 2020-2021 was asked of all registrants of the largest electronic personal health record in the NHS by a web-based questionnaire on July 31, 2020. Of those who were either newly or previously eligible but had not previously received an influenza vaccination, multivariable logistic regression and network diagrams were used to examine their reasons to undergo or decline vaccination.

Results

Among 6641 respondents, 945 (14.2%) were previously eligible but were not vaccinated; of these, 536 (56.7%) intended to receive an influenza vaccination in 2020-2021, as did 466 (68.6%) of the newly eligible respondents. Intention to receive the influenza vaccine was associated with increased age, index of multiple deprivation quintile, and considering oneself to be at high risk from COVID-19. Among those who were eligible but not intending to be vaccinated in 2020-2021, 164/543 (30.2%) gave reasons based on misinformation. Of the previously unvaccinated health care workers, 47/96 (49%) stated they would decline vaccination in 2020-2021.

Conclusions

In this sample, COVID-19 has increased acceptance of influenza vaccination in previously eligible but unvaccinated people and has motivated substantial uptake in newly eligible people. This study is essential for informing resource planning and the need for effective messaging campaigns to address negative misconceptions, which is also necessary for COVID-19 vaccination programs.

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  1. Version published to 10.2196/26734
  2. Version published to 10.2196/preprints.26734
  3. ScreenIT

    SciScore for 10.1101/2020.10.01.20205385: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Study Participants: Participants in this study were registrants of the Care Information Exchange (CIE) of Imperial College Healthcare NHS Foundation Trust (UK).
    College Healthcare
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has several limitations. These results are only indicative; whether participants stick to their response when faced with flu vaccination is uncertain. However, previous studies have shown good correlation between declared questionnaire responses and subsequent behaviour.35–37 Those who turned 65 or became a healthcare worker in the last year and who did not receive a flu vaccination in 2019/20 were potentially mis-classified. Use of the CIE implies a higher agency over one’s health, and notably the previously eligible population had a higher baseline uptake (79.6%) than last year’s national average (70.6%). The number of healthcare workers in the sample was low, limiting the generalisability of reasons for and against new uptake, though the prevalent belief that the vaccine ‘gives me flu’ is reflected in other studies of healthcare workers,38 among whom low uptake remains a challenge.39 Misconceptions and false beliefs around the flu vaccine are common and harmful, and follow a socioeconomic gradient.40 Therefore a further limitation is the under-representation of ethnic minorities, also known to have lower uptake of all forms of vaccination.41 As well as potentially explaining the relative absence in the network analysis of logistical reasons, such as getting time off work to attend an appointment, this shortcoming in representativeness may have resulted in slightly overestimated acceptance rates. The need to understand the Covid-19 pandemic’s impact on acceptabil...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  4. Version published to 10.1101/2020.10.01.20205385v1 on medRxiv