Impact of COVID-19 on Influenza Vaccination Attitudes and Patient Satisfaction
Overview
The COVID-19 pandemic significantly altered influenza vaccination behaviors and patient satisfaction among adult primary care patients in southeastern Minnesota. Notably, a substantial proportion of previously intermittently vaccinated individuals ceased influenza vaccination during the pandemic, with vaccine refusal linked to socioeconomic deprivation, lower education, and healthcare disengagement.
Background
Seasonal influenza vaccination is critical in reducing hospitalizations and deaths related to influenza, yet vaccination coverage in the U.S. has declined since 2020, particularly among high-risk groups. Vaccine hesitancy, influenced by factors such as complacency, confidence, and convenience, complicates vaccination efforts. The COVID-19 pandemic has underscored the need to understand adult vaccination behaviors and the role of patient satisfaction in influencing vaccine uptake.
Data Highlights
Vaccination Status
Prepandemic Phase
Pandemic-Plus Phase
Always Vaccinated (AV)
Baseline
7.0% (n=3556) never received another influenza vaccine
Intermittently Vaccinated (IV)
Baseline
48.7% (n=16,710) never received another influenza vaccine
Odds Ratios for Socioeconomic Deprivation (vs AV)
IV: 1.58 (95% CI 1.53–1.62)
NV: 1.99 (95% CI 1.94–2.05)
Odds Ratios for Education ≤ High School (vs AV)
IV: 2.86 (95% CI 2.74–2.98)
NV: 3.38 (95% CI 3.23–3.53)
Odds Ratios for Healthcare Disengagement (vs AV)
IV: 1.59 (95% CI 1.55–1.64)
NV: 4.21 (95% CI 4.09–4.33)
Adjusted Healthcare Disengagement Increase (NV vs AV)
Prepandemic: 3.33 (95% CI 3.24–3.41)
Pandemic-Plus: 4.23 (95% CI 4.10–4.35)
Severe Comorbidities - Likelihood of NV vs AV
1.21 (95% CI 1.14–1.27)
Severe Comorbidities - Dissatisfaction NV vs AV
1.25 (95% CI 1.18–1.33)
Key Findings
During the pandemic, 48.7% of previously intermittently vaccinated patients stopped receiving influenza vaccines.
Patients who never or intermittently vaccinated were more likely to live in socioeconomically deprived areas and have lower education levels.
Healthcare disengagement was significantly higher among never vaccinated patients, increasing further during the pandemic.
Patients with severe comorbidities were less likely to be always vaccinated and reported higher dissatisfaction with care.
The COVID-19 pandemic exacerbated disparities in vaccination behaviors and patient satisfaction, particularly among high-risk populations.
Clinical Implications
Healthcare providers should recognize that vaccine refusal is associated with socioeconomic and educational disadvantages as well as healthcare disengagement, which have intensified during the COVID-19 pandemic. Targeted interventions addressing these factors, alongside efforts to improve patient satisfaction, may enhance influenza vaccination uptake, especially in high-risk groups. Public health strategies should incorporate these insights to mitigate influenza-related morbidity and mortality.
Conclusion
The COVID-19 pandemic has significantly impacted influenza vaccination patterns and patient satisfaction, highlighting the need for tailored approaches to address vaccine hesitancy and healthcare engagement. Understanding these dynamics is essential to improving vaccination coverage and patient outcomes.
References
Centers for Disease Control and Prevention 2020 -- Seasonal Influenza Vaccination Coverage
CDC 2020 -- Influenza Burden Estimates
World Health Organization -- Vaccine Hesitancy Definition
A global systematic review of 173 studies found differing associations between COVID-19 infection and vaccination and retinal vascular events, with retinal artery occlusion more common after infection and retinal vein occlusion more common after vaccination.
