Khan Akram, Zhu Yuwei, Babcock Hilary M, Busse Laurence W, Duggal Abhijit, Exline Matthew C, Gaglani Manjusha, Gibbs Kevin W, Gong Michelle N, Ginde Adit A, Hager David N, Hope Aluko A, Hyde Jessica, Johnson Nicholas J, Kwon Jennie H, Mohr Nicholas M, O'Rourke Mary, Peltan Ithan D, Mallow Christopher, Qadir Nida, Reddy Raju, Safdar Basmah, Shapiro Nathan I, Sohn Ine, Steingrub Jay S, Wilson Jennifer G, Baughman Adrienne, Womack Kelsey N, Rhoads Jillian P, Self Wesley H, Stubblefield William B
Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Oregon Health and Sciences University, Portland, OR, USA.
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
Vaccine. 2025 Feb 27;48:126806. doi: 10.1016/j.vaccine.2025.126806. Epub 2025 Jan 30.
Understanding similarities and differences between hesitancy for influenza and COVID-19 vaccines could facilitate strategies to improve public receptivity toward vaccination.
We compared hesitancy for COVID-19 vaccines during the first 13 months of availability (January 2021-January 2022) with hesitancy for influenza vaccines in the 15 months prior to COVID-19 vaccine availability (October 2019-December 2020) among adults hospitalized with acute respiratory illness at 21 hospitals in the United States. We interviewed patients regarding vaccination status, willingness to be vaccinated, and perceptions of vaccine safety and efficacy. We used multivariate logistic regression to identify factors associated with vaccine hesitancy.
Among 12,292 patients enrolled during the COVID-19 vaccine period, 5485 (44.6 %) were unvaccinated. Patient characteristics associated with not receiving the COVID-19 vaccine included younger age, female sex, higher BMI, lack of health insurance, absence of chronic comorbid medical conditions, no or rare influenza vaccination in prior years, higher CDC social vulnerability index (SVI), a measure of external stresses that may negatively impact health, living in the Midwest or southern US, lack of college or higher education, and not wearing a mask. Among 983 patients enrolled during the influenza vaccination period, 381(37.8 %) were unvaccinated. Characteristics associated with not receiving the influenza vaccine included no or one chronic comorbid medical condition, no or rare influenza vaccination in prior years, being a current smoker, and higher SVI. Discussion with healthcare providers was a reason for vaccination for 27.7 % (167) for influenza and 8.3 % (564) for COVID-19 and to decline vaccination for 0.5 % Ten great public health achievements-United States (2011) (2) for influenza and 2.2 % (118) for COVID-19.
We found that higher SVI scores and lack of prior influenza vaccination were associated with hesitancy for both COVID-19 and influenza vaccines. There were regional variations in COVID-19 vaccine acceptance and discussions with HCPs significantly influenced acceptance for both vaccines.
了解对流感疫苗和新冠疫苗的犹豫态度之间的异同，有助于制定提高公众对疫苗接种接受度的策略。
我们将2021年1月至2022年1月这13个月期间美国21家医院因急性呼吸道疾病住院的成年人对新冠疫苗的犹豫态度，与新冠疫苗可用前15个月（2019年10月至2020年12月）对流感疫苗的犹豫态度进行了比较。我们就患者的疫苗接种状况、接种意愿以及对疫苗安全性和有效性的看法对患者进行了访谈。我们使用多因素逻辑回归来确定与疫苗犹豫相关的因素。
在新冠疫苗接种期间登记的12292名患者中，5485名（44.6%）未接种疫苗。与未接种新冠疫苗相关的患者特征包括年龄较小、女性、体重指数较高、没有医疗保险、没有慢性合并症、前几年未接种或很少接种流感疫苗、疾病控制与预防中心社会脆弱性指数（SVI）较高（这是一种可能对健康产生负面影响的外部压力衡量指标）、居住在美国中西部或南部、未接受过大学或更高教育以及未佩戴口罩。在流感疫苗接种期间登记的983名患者中，381名（37.8%）未接种疫苗。与未接种流感疫苗相关的特征包括没有或有一种慢性合并症、前几年未接种或很少接种流感疫苗、当前吸烟者以及SVI较高。与医疗保健提供者的讨论是27.7%（167名）流感疫苗接种者和8.3%（564名）新冠疫苗接种者接种疫苗的原因，也是0.5%的流感疫苗接种者和2.2%（118名）新冠疫苗接种者拒绝接种疫苗的原因。
我们发现，较高的SVI分数和之前未接种流感疫苗与对新冠疫苗和流感疫苗的犹豫态度相关。新冠疫苗的接受情况存在地区差异，与医疗保健提供者的讨论对两种疫苗的接受情况均有显著影响。
