Adult influenza vaccination coverage before, during and after the COVID-19 pandemic in Canada

Ruoke Chen · Nicolas L. Gilbert · Ève Dubé

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Vaccine Coverage and Hesitancy Influenza Virus Research Studies Respiratory viral infections research

Abstract

BACKGROUND: Vaccination prevents seasonal influenza and its complications, particularly among high-risk populations. The COVID-19 pandemic has been reported to impact healthcare behaviors and vaccination patterns. This study aims to assess influenza vaccination coverage and changes in vaccination settings among Canadian adults from the 2018-2019 to the 2023-2024 seasons. METHOD: We conducted a retrospective analysis of data from multiple cycles of the Seasonal Influenza Vaccination Coverage Survey (SIVCS). Vaccination coverage was examined across different seasons, stratified by population groups. Odds ratios (ORs) were calculated to compare vaccination likelihoods across seasons, with 2018-2019 serving as the reference. Chi-square tests were applied to determine whether there were significant differences in the place of vaccination since the pre-pandemic season. RESULTS: When comparing vaccine uptake before, during and after the COVID-19 pandemic, we observed a temporary coverage decline in 2021-2022 season (OR = 0.882, 95% CI = 0.787-0.988) compared to the pre-pandemic season in 2018-2019. By the 2022-2023 and 2023-2024 seasons, vaccination coverage returned to pre-pandemic levels. Coverage among adults aged 18-64 without chronic medical condition consistently remained lower than in other groups. The places of vaccination shifted markedly, with pharmacies becoming the predominant site, increasing from 35.4% in 2018-2019 to 57.4% in 2023-2024, while doctor's offices saw a decline from 32.7 to 15.2% over the same period. CONCLUSION: Our findings highlight the transient effect of the pandemic on flu vaccine uptake in Canada. The increasing use of pharmacies for vaccinations underscores the importance of accessible and convenient vaccination sites. Future efforts should focus on maintaining and improving vaccination coverage through diverse and adaptable vaccination settings.

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References

2020Vaccine hesitancy: the next challenge in the fight against COVID-19 2022The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good 2020Vaccines and routine immunization strategies during the COVID-19 pandemic 2021The Impact of the COVID-19 Pandemic on Immunization Campaigns and Programs: A Systematic Review 2021Parental Perspectives on Immunizations: Impact of the COVID-19 Pandemic on Childhood Vaccine Hesitancy 2015Perceptions and Behavioral Responses of the General Public During the 2009 Influenza A (H1N1) Pandemic: A Systematic Review 2021Impact of COVID-19 pandemic on routine immunization 2020Willingness to Vaccinate Children against Influenza after the Coronavirus Disease 2019 Pandemic

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