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. 2024 Dec 31;20(1):2428017.
doi: 10.1080/21645515.2024.2428017. Epub 2024 Nov 13.

Impact of propensity to COVID-19 vaccination/vaccine on influenza vaccination from willingness to behavior among older adults in rural China

Shan-Shan Zhang  1 , Wanna Shi  2 , Juan Du  1   3 , Wan-Xue Zhang  1   2   3 , Mengjun Yuan  4 , Yiguo Zhou  1   3   5 , Lili Wang  6 , Tianshuo Zhao  1   2   3 , Qin-Yi Ma  1   2   3 , Sihui Zhang  1   2   3 , Han Yang  1   2   3 , Xiyu Zhang  1   2   3 , Mingting Wang  1   2   3 , Ninghua Huang  1   3   7 , Jing Zeng  1   3   7 , Yaqiong Liu  1 , Yuanshan Zhang  8 , Fuqiang Cui  1   2   3   5 , Qing-Bin Lu  1   2   3   5
Affiliations

Impact of propensity to COVID-19 vaccination/vaccine on influenza vaccination from willingness to behavior among older adults in rural China

Shan-Shan Zhang et al. Hum Vaccin Immunother. .

Abstract

To explore impact of the propensity to coronavirus disease 2019 (COVID-19) vaccine/vaccination on influenza vaccination from willingness to behavior after COVID-19 pandemic among older adults in rural China. A combined study involving a cross-sectional survey for the willingness of influenza vaccination, a health education momentary intervention and a community intervention program were conducted from September 11th to 16th, 2023 among rural older adults in China. Totally 3138 individuals were investigated in this study with 1923 (61.3%) willing to receive influenza vaccination. After the momentary intervention, 47.8% (582/1215) individuals changed to be willing to receive influenza vaccination. There were 1440 (78.8%) vaccinated. The influenza vaccination willingness rate was significantly higher in the participants willing to receive COVID-19 vaccine booster dose vaccination than the participants unwilling to (69.4% vs. 37.7%, adjusted OR [aOR] = 2.671, 95% CI 2.211-3.227, p < .001), as well as for the influenza vaccination willingness change rate (52.2% vs. 41.7%, aOR = 1.303, 95% CI 1.022-1.662, p < .05) and the influenza vaccination behavior rate (79.7% vs. 74.9%, aOR = 1.337, 95% CI 1.002-1.784, p < .05). The influenza vaccination behavior rate was significantly higher in those positive toward COVID-19 vaccine effectiveness or safety overall (80.0% vs. 74.9%, aOR = 1.394, 95% CI 1.065-1.823; 80.6% vs. 70.9%, aOR = 1.850, 95% CI 1.395-2.454; both p < .05). There was a positive impact of COVID-19 vaccine/vaccination on influenza vaccination from willingness to behavior among the older adults in rural China after COVID-19 pandemic, suggesting that integrating health education of related pathogens and vaccines might promote influenza vaccination.

Keywords: COVID-19; behavior; influenza; vaccination; willingness.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
The flowchart of study design and data analysis. The left part was the study design and showed the sample size in each step. The right part was the description of data analysis including the aim, variables and methods.
Figure 2.
Figure 2.
The characteristics influencing COVID-19 vaccine booster dose vaccination willingness and the attitude toward COVID-19 vaccine. The latter in the bracket was the reference group. Datapoints and the error bars indicate odds ratios and 95% CI. Only statistically significant results (p < .05) were displayed (in red) in this forest plot.
Figure 3.
Figure 3.
The impact of COVID-19 vaccination willingness on influenza vaccination. a. The rate of influenza vaccination willingness and its association with COVID-19 vaccine booster dose vaccination willingness. b. The rate of influenza vaccination willingness change and its association with COVID-19 vaccine booster dose vaccination willingness. c. The rate of influenza vaccination behavior and its association with COVID-19 vaccine booster dose vaccination willingness. The red and blue bars show the corresponding rates of positive propensity group and negative propensity group for COVID-19 vaccine booster dose vaccination willingness, respectively. The datapoints and the error bars indicate odds ratios and 95% CI. The red color represents p < .05 and the black color represents p ≥ .05.
Figure 4.
Figure 4.
The impact of the attitude toward COVID-19 vaccine effectiveness on influenza vaccination. (a) The rate of influenza vaccination willingness and its association with the attitude toward COVID-19 vaccine effectiveness. (b) The rate of influenza vaccination willingness change and its association with the attitude toward COVID-19 vaccine effectiveness. (c) The rate of influenza vaccination behavior and its association with the attitude toward COVID-19 vaccine effectiveness. The red and blue bars show the corresponding rates of positive propensity group and negative propensity group for COVID-19 vaccine effectiveness, respectively. The datapoints and the error bars indicate odds ratios and 95% CI. The red color represents p < .05 and the black color represents p ≥ .05.
Figure 5.
Figure 5.
The impact of the attitude toward COVID-19 vaccine safety on influenza vaccination. a. The rate of influenza vaccination willingness and its association with the attitude toward COVID-19 vaccine safety. b. The rate of influenza vaccination willingness change and its association with the attitude toward COVID-19 vaccine safety. c. The rate of influenza vaccination behavior and its association with the attitude toward COVID-19 vaccine safety. The red and blue bars show the corresponding rates of positive propensity group and negative propensity group for COVID-19 vaccine safety, respectively. The datapoints and the error bars indicate odds ratios and 95% CI. The red color represents p < .05 and the black color represents p ≥ .05.
Figure 6.
Figure 6.
The characteristic differences of patients with different propensity to influenza vaccination. (a) The association between participant characteristics and influenza vaccination willingness, willingness change or behavior in the subgroup willing to receive COVID-19 vaccine booster dose vaccination. (b) The association between participant characteristics and influenza vaccination willingness or willingness change in the subgroup unwilling to receive COVID-19 vaccine booster dose vaccination. (c) The association between participant characteristics and influenza vaccination willingness, willingness change or behavior in the subgroup positive toward COVID-19 vaccine effectiveness. (d) The association between participant characteristics and influenza vaccination willingness, willingness change or behavior in the subgroup negative toward COVID-19 vaccine effectiveness. (e) The association between participant characteristics and influenza vaccination willingness, willingness change or behavior in the subgroup positive toward COVID-19 vaccine safety. (f) The association between participant characteristics and influenza vaccination willingness, willingness change or behavior in the subgroup negative toward COVID-19 vaccine safety. The latter in the bracket was the reference group. Datapoints and the error bars indicate odds ratios and 95% CI. Only statistically significant results (p < .05) were displayed (in red) in this forest plot.
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