key: cord-0825008-nfihnsat
authors: Veluri, Nikhila; Injeti, Rohit; Jain, Pratik
title: Observing willingness of obtaining the influenza vaccine during and after COVID-19 Flu vaccination and COVID-19
date: 2020-11-21
journal: Public health in practice
DOI: 10.1016/j.puhip.2020.100057
sha: 5ff2921af5874b8b935e36717a017d722e3bdeb1
doc_id: 825008
cord_uid: nfihnsat

nan

Between September to early January, the influenza vaccine (henceforth defined as flu vaccine) is released for the public [1] . The Centers for Disease Control and Prevention (CDC) recommends that all individuals older than six months of age obtain the annual flu vaccine, as it is the first step in preventing the influenza virus [1] . Nevertheless, from 2017 to 2018, only 42% of the United States population was estimated to be covered by the vaccine [2] , a considerably low percentage.

During the 2003 flu season, which was towards the end of the Severe Respiratory Distress Syndrome (SARS-CoV-1) outbreak, 66% of individuals older than 65 reported receiving the flu vaccine [3] . This percentage decreased the following year to 63% [3] . The immediate reduction raises concern as it appears that peoples' perception of the need for the flu vaccine decreases as imminent danger subsides, like the SARS-CoV-1.

The Coronavirus pandemic (COVID-19) has currently resulted in 213 614 deaths in America [4] .

Countries around the world are working towards developing a vaccine for the COVID-19. While this vaccine will significantly aid the severely affected hospitalized individuals, the question arises as to whether individuals outside this population group will even obtain the vaccine, especially when the overall percentage of obtaining the flu vaccine is as low as 42-49% [2] .

This study's authors conducted a survey whose primary objective was to observe whether the current COVID-19 pandemic will reshape flu vaccination rates this current year and over the next five years.

An online survey-based design was available to participants from August 5 to September 3, 2020, on social networking platforms. The study's nature, the anonymity of participants' identities, and information regarding data usage were explained before the survey began. Informed consent was defined as participants agreeing to complete the survey after reading through the purpose of the survey and data analysis. Respondents were required to be 18 years of age to be eligible to answer the survey questions.

The estimated length of time for completion of the survey was two to five minutes.

A total of 508 participants were recruited and utilized the data from 507 participants. Data collected from participants included demographic characteristics, interest obtaining in the COVID-19 vaccine, and whether they obtained or willing to obtain the flu vaccine (i) in 2019, (ii) this current flu season, and (iii) over the next five years. In an attempt to understand the hesitancy of peoples' unwillingness to seek the flu vaccine, participants responding "no" to questions (iii) to (iv) were prompted to answer "why not?"

While this study has methodological flaws that interfere with strict scientific protocol, it nevertheless offers important behavioural trends. Using SPSS, the chi-square likelihood ratio (G 2 ) and the odds ratio (OR) were calculated to assess any significant associations. The confidence interval (CI) was set at 95% for all analyses. 88-101.03, p=0.01, respectively) .

The common factors that attributed to the reluctance to obtaining the flu vaccine this year and over the next five years were: the perception that they do not require the vaccine (17% and 15%, respectively), vaccination does more harm than good (2.76% and 2.37%, respectively) and a lack of belief in vaccination (2.37%). The most common reason for individuals denying interest in obtaining the COVID-19 vaccine was potential side effects and further evaluation (6.9%).

The associations from this study should be cautiously interpreted, as there were limitations present. Asian individuals comprised 79.7% of the respondents, and 50.3% and 35.5% of responses were from individuals residing in Asia and North America. Thus, generalizations from these results would be inappropriate. However, this study's authors used this survey to serve as a preliminary step in examining people's perceptions regarding flu vaccination, specifically during the COVID-19 pandemic. Although the COVID-19 pandemic did not influence individuals' perception of vaccination, it is essential to note the behavioral trend. Individuals that obtained a flu vaccine last year were likely to obtain a flu vaccine this year, and individuals who would obtain a flu vaccine this year were likely to obtain a flu vaccine over the next five years. This behavioural trend can guide clinicians in understanding the importance of encouraging and educating patients about flu vaccination clearly and concisely.

As the second wave of the pandemic has begun, the resources allocated towards COVID-19 must remain precisely for that. Individuals experiencing flu-like symptoms may believe that they are experiencing symptoms of COVID-19 and obtain unnecessary testing, which can be significantly reduced by individuals obtaining the flu vaccine this year. Therefore, prompt encouragement and clear education may alleviate individuals' concerns regarding flu vaccination and influence them to obtain the vaccine this year and over the next five years.

Frequently asked influenza (flu) questions: 2019-2020 season

Centers for Disease Control and Prevention (CDC). 2010-11 through 2019-20 influenza seasons vaccination coverage trend report

Influenza vaccination coverage among adults and children-United States

United States COVID-19 cases and deaths by state

Dear Dr. Lee and Dr. Morling, I wish to submit this brief survey study, titled "Observing the willingness of obtaining the influenza vaccine during and after COVID-19," as a letter to the editor in the journal Public Health in Practice.This study examined the influence of the current COVID-19 pandemic on an individual's willingness to obtain the influenza vaccine. We deployed a web-based survey, where participants answered sociodemographic questions (e.g., age, sex, ethnicity, country of residence, level of education, and annual income) and vaccination questions: (i) if they obtained the flu vaccine in 2019, (ii) if they would obtain the COVID-19 vaccine, if it becomes available, (iii) if they would obtain the flu vaccine during the 2020 flu season, and (iv) if they would obtain the flu shot during the next five years. Prior to participating in the survey, individuals were informed of the study's purpose and how the collected data would be utilized. Respondents younger than 18 years of age were not allowed to participate. We did not collect any identifying information from the participants, and identities were kept completely anonymous.Our results displayed that the most determining factor in obtaining the flu shot this current flu season was based on if an individual received the flu shot last year in 2019. Additionally, the five-year willingness to obtain the flu shot was significantly associated with obtaining the flu shot this current flu season.Further, we believe that this paper will be of interest to your journal's readership because it underscores the importance of clinicians encouraging patients to obtain the flu vaccine, as this will benefit the patients during this current pandemic and increases the likelihood of re-vaccination in the next five years. This manuscript has not been published or presented elsewhere in part or entirety and is not under consideration by another journal. We have read and understood your journal's policies, and we believe that the manuscript does not violate any of these. There are no conflicts of interest to declare.Thank you for your consideration. I look forward to hearing from you.Sincerely, Nikhila Veluri, MD American University of Integrative Sciences, SOM nveluri@auis.edu J o u r n a l P r e -p r o o f

☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.☐The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:J o u r n a l P r e -p r o o f