LATEBREAKER
COVID-19 Pandemic
Influenza Vaccination Rates Before and During the COVID-19 Pandemic in the USA Lasata Shrestha* Lasata Shrestha Mahima Joshi Shivani Paudel McKenna Eastment Alyson Littman
The United States Centers for Disease Control (CDC) estimated that influenza (flu) contributed to 4900– 52000 deaths annually between 2010 and 2022. Despite annual vaccination being the most effective preventive measure, flu vaccination rates in the US for the last decade have been lower (less than 65%) than the Healthy People 2020 Initiatives’ desired target of 70%. The lower flu vaccination could be related to disparities in access to vaccine and vaccine coverage, health literacy, race, geographical location, and differences in healthcare decision-making, which the COVID-19 pandemic further exacerbated. Using the Behavioral Risk Factor Surveillance System (BRFSS) dataset, we compared the flu vaccine uptake rates before the COVID-19 pandemic (unexposed: 2018-2019) to those during the pandemic (exposed: 2020-2021). Flu vaccine uptake prevalence ratios (PR) were calculated using generalized linear models, adjusted for household income, self-reported health, age, insurance coverage, sex, and education. Additionally, effect modification by Medicaid expansion, race/ ethnicity, and urbanicity/rurality was examined, but since there were no meaningful differences in the during vs. pre-pandemic associations by these factors, they were instead adjusted for in the final analyses. The prevalence of flu vaccination before the pandemic was 44.4% compared to 52.6% during the pandemic (aPR= 1.19, 95%CI 1.18, 1.19). Associations were similar after adjustment for potential confounders (aPR = 1.19, 95%CI 1.18, 1.19). This study highlights the pandemic-driven difference in flu vaccination rates and the importance of understanding the impact of the COVID-19 pandemic on health-seeking behaviors in various communities.