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. 2023 Feb 3;41(6):1190-1197.
doi: 10.1016/j.vaccine.2022.12.052. Epub 2022 Dec 23.

Receipt of COVID-19 and seasonal influenza vaccines in California (USA) during the 2021-2022 influenza season

Kristin L Andrejko  1 , Jennifer F Myers  2 , John Openshaw  2 , Nozomi Fukui  1 , Sophia Li  3 , James P Watt  2 , Erin L Murray  2 , Cora Hoover  2 , Joseph A Lewnard  4 , Seema Jain  2 , Jake M Pry  5 ; California COVID-19 Case-Control Study Team
Affiliations

Receipt of COVID-19 and seasonal influenza vaccines in California (USA) during the 2021-2022 influenza season

Kristin L Andrejko et al. Vaccine. .

Abstract

Background: Despite lower circulation of influenza virus throughout 2020-2022 during the COVID-19 pandemic, seasonal influenza vaccination has remained a primary tool to reduce influenza-associated illness and death. The relationship between the decision to receive a COVID-19 vaccine and/or an influenza vaccine is not well understood.

Methods: We assessed predictors of receipt of 2021-2022 influenza vaccine in a secondary analysis of data from a case-control study enrolling individuals who received SARS-CoV-2 testing. We used mixed effects logistic regression to estimate factors associated with receipt of seasonal influenza vaccine. We also constructed multinomial adjusted marginal probability models of being vaccinated for COVID-19 only, seasonal influenza only, or both as compared with receipt of neither vaccination.

Results: Among 1261 eligible participants recruited between 22 October 2021-22 June 2022, 43% (545) were vaccinated with both seasonal influenza vaccine and >1 dose of a COVID-19 vaccine, 34% (426) received >1 dose of a COVID-19 vaccine only, 4% (49) received seasonal influenza vaccine only, and 19% (241) received neither vaccine. Receipt of >1 COVID-19 vaccine dose was associated with seasonal influenza vaccination (adjusted odds ratio [aOR]: 3.72; 95% confidence interval [CI]: 2.15-6.43); this association was stronger among participants receiving >1 COVID-19 booster dose (aOR = 16.50 [10.10-26.97]). Compared with participants testing negative for SARS- CoV-2 infection, participants testing positive had lower odds of receipt of 2021-2022 seasonal influenza vaccine (aOR = 0.64 [0.50-0.82]).

Conclusions: Recipients of a COVID-19 vaccine were more likely to receive seasonal influenza vaccine during the 2021-2022 season. Factors associated with individuals' likelihood of receiving COVID-19 and seasonal influenza vaccines will be important to account for in future studies of vaccine effectiveness against both conditions. Participants who tested positive for SARS-CoV-2 in our sample were less likely to have received seasonal influenza vaccine, suggesting an opportunity to offer influenza vaccination before or after a COVID-19 diagnosis.

Keywords: COVID-19; California; Case-control study; Influenza; Vaccination.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: co-author J.A.L. discloses receipt of grants and honoraria from Pfizer, Inc, outside the submitted work. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Fig. 1
Fig. 1
Marginal probability of receipt of an influenza vaccination. Estimates are derived from multinomial models and are presented by A) age category B) SARS-CoV-2 test month associated with parent study enrollment C) race/ethnicity D) region. Abbreviations: CI – confidence interval.
See this image and copyright information in PMC

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