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

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Abstract

Background

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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Most cited references 30

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Fighting COVID-19 Misinformation on Social Media: Experimental Evidence for a Scalable Accuracy-Nudge Intervention

Gordon Pennycook, Jonathon McPhetres, Yunhao Zhang … (2020)

Across two studies with more than 1,700 U.S. adults recruited online, we present evidence that people share false claims about COVID-19 partly because they simply fail to think sufficiently about whether or not the content is accurate when deciding what to share. In Study 1, participants were far worse at discerning between true and false content when deciding what they would share on social media relative to when they were asked directly about accuracy. Furthermore, greater cognitive reflection and science knowledge were associated with stronger discernment. In Study 2, we found that a simple accuracy reminder at the beginning of the study (i.e., judging the accuracy of a non-COVID-19-related headline) nearly tripled the level of truth discernment in participants’ subsequent sharing intentions. Our results, which mirror those found previously for political fake news, suggest that nudging people to think about accuracy is a simple way to improve choices about what to share on social media.

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Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study

Alexandre de Figueiredo, Clarissa Simas, Emilie N Karafillakis … (2020)

Summary Background There is growing evidence of vaccine delays or refusals due to a lack of trust in the importance, safety, or effectiveness of vaccines, alongside persisting access issues. Although immunisation coverage is reported administratively across the world, no similarly robust monitoring system exists for vaccine confidence. In this study, vaccine confidence was mapped across 149 countries between 2015 and 2019. Methods In this large-scale retrospective data-driven analysis, we examined global trends in vaccine confidence using data from 290 surveys done between September, 2015, and December, 2019, across 149 countries, and including 284 381 individuals. We used a Bayesian multinomial logit Gaussian process model to produce estimates of public perceptions towards the safety, importance, and effectiveness of vaccines. Associations between vaccine uptake and a large range of putative drivers of uptake, including vaccine confidence, socioeconomic status, and sources of trust, were determined using univariate Bayesian logistic regressions. Gibbs sampling was used for Bayesian model inference, with 95% Bayesian highest posterior density intervals used to capture uncertainty. Findings Between November, 2015, and December, 2019, we estimate that confidence in the importance, safety, and effectiveness of vaccines fell in Afghanistan, Indonesia, Pakistan, the Philippines, and South Korea. We found significant increases in respondents strongly disagreeing that vaccines are safe between 2015 and 2019 in six countries: Afghanistan, Azerbaijan, Indonesia, Nigeria, Pakistan, and Serbia. We find signs that confidence has improved between 2018 and 2019 in some EU member states, including Finland, France, Ireland, and Italy, with recent losses detected in Poland. Confidence in the importance of vaccines (rather than in their safety or effectiveness) had the strongest univariate association with vaccine uptake compared with other determinants considered. When a link was found between individuals' religious beliefs and uptake, findings indicated that minority religious groups tended to have lower probabilities of uptake. Interpretation To our knowledge, this is the largest study of global vaccine confidence to date, allowing for cross-country comparisons and changes over time. Our findings highlight the importance of regular monitoring to detect emerging trends to prompt interventions to build and sustain vaccine confidence. Funding European Commission, Wellcome, and Engineering and Physical Sciences Research Council.

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Obesity and its Implications for COVID-19 Mortality

William A. Dietz, Carlos Santos-Burgoa (2020)

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Author and article information

Contributors

Nicholas S Peters:

ORCID: https://orcid.org/0000-0002-3581-8078

National Heart & Lung InstituteImperial College London4th Floor ICTEM BuildingHammersmith Campus, Du Cane RoadLondon, W12 0NNUnited Kingdom44 020 7589 5111n.peters@imperial.ac.uk

Journal

Journal ID (nlm-ta): JMIR Public Health Surveill

Journal ID (iso-abbrev): JMIR Public Health Surveill

Journal ID (publisher-id): JPH

Title: JMIR Public Health and Surveillance

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2369-2960

Publication date Collection: April 2021

Publication date (Electronic): 14 April 2021

Publication date PMC-release: 14 April 2021

Volume: 7

Issue: 4

Electronic Location Identifier: e26734

Affiliations

[1 ] National Heart & Lung Institute Imperial College London London United Kingdom

Author notes

Corresponding Author: Nicholas S Peters n.peters@ 123456imperial.ac.uk

Author information

Patrik Bachtiger https://orcid.org/0000-0002-3502-8869

Alexander Adamson https://orcid.org/0000-0003-0265-5900

Ji-Jian Chow https://orcid.org/0000-0003-2454-7644

Rupa Sisodia https://orcid.org/0000-0002-3640-4213

Jennifer K Quint https://orcid.org/0000-0003-0149-4869

Nicholas S Peters https://orcid.org/0000-0002-3581-8078

Article

Publisher ID: v7i4e26734

DOI: 10.2196/26734

PMC ID: 8048709

PubMed ID: 33651708

SO-VID: 973ebec4-341e-444d-8236-828c36c826fb

Copyright © ©Patrik Bachtiger, Alexander Adamson, Ji-Jian Chow, Rupa Sisodia, Jennifer K Quint, Nicholas S Peters. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 14.04.2021.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on http://publichealth.jmir.org, as well as this copyright and license information must be included.

History

Date received : 23 December 2020

Date revision requested : 20 January 2021

Date revision received : 7 February 2021

Date accepted : 18 February 2021

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