Article
Vaccine hesitancy and uptake of influenza vaccination in (post-)pandemic seasons – applying the 7-C framework in an epidemic panel (MuSPAD)
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Authors
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Carolina J. Klett-Tammen
- Abteilung Epidemiologie, Helmholtz-Zentrum für Infektionsforschung, Braunschweig, Braunschweig, Germany
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Dörthe Meyerdierks
- Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
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Manuela Harries
- HZI, Braunschweig, Germany
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Robyn Kettlitz
- Helmholtz Centre for Infection Research, Braunschweig, Germany
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Maren Sophia Wieder
- Helmholtz-Zentrum für Infektionsforschung, Braunschweig, Germany
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Stefanie Castell
- Helmholtz-Zentrum für Infektionsforschung, Braunschweig, Germany
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. RESPINOW Study Group
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Berit Lange
- Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| Published: | September 6, 2024 |
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Outline
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Background: Evidence indicates vaccination uptake has changed during and after the pandemic, including influenza. The direction of the changes varies according to study and subpopulation. Among the most important predictors of influenza vaccine uptake are personal perceptions of the respective vaccine and the underlying health conditions. One established framework to evaluate these is the 7-C model on vaccine hesitancy. This validated scale assesses Confidence, Complacency, Constraints, Calculation, Collective, Compliance, and Conspiracy. Our aim is to investigate potential variations in influenza vaccine uptake among individuals aged ≥60 years during and after the COVID-19 pandemic, as well as potential differences in vaccine hesitancy based on vaccination status.
Methods: The epidemic panel MuSPAD (Multilocal and Serial Prevalence Study of Antibodies against (Respiratory) Infectious Diseases in Germany) was initiated in 2020 to assess the prevalence of SARS-CoV-2 antibodies within the general population in Germany. A sub-cohort started in 2023, focusing on questions regarding preventive behavior including vaccinations. We analyzed data on reported vaccine uptake (actual and intended) from the seasons 2021/22 and 2023/24 to compare the influenza vaccine uptake during and after the pandemic. In 2023/24 the 7-C scale was implemented in the sub-cohort. For the analyses we included all participants of 60 years and older. We analyzed a) the influenza vaccine uptake across various seasons, b) the vaccine hesitancy according to the 7-C scale and c) the medians of the 7-C scale stratified by vaccine uptake using Wilcoxon-ranksum-test. We calculated the individual means of the items of each category and the median for each category. Lower values indicate higher vaccination hesitancy. All analyses were carried out using Stata/BE 18.
Results: Of the eligible 2,757 participants in the season 2021/22, 1,329 (48.2%) individuals were at least 60 years old, while of the 1,562 eligible participants in season 2023/24, 517 (33.1 %) were at least 60 years old. The vaccine uptake was 74.9% (996/1,329; 95% CI= 72.5-77.3) in the season 2021/22 and 76.4% (366/479; 95% CI= 72.3-80.1) in 2023/24. Across all categories of the 7C-model higher scores were obtained for those vaccinated, this varied from 4.3 in Calculation to 6.3 in Complacency in the vaccinated and from 3.0 in Calculation to 5.0 in Complacency and Collective Responsibility in the unvaccinated. All differences were significant.
Conclusions: We found stable uptake between the pandemic years and the post-pandemic seasons and indications of associations of vaccine hesitancy and the uptake of the influenza vaccine in the season 2023/24. We found different variations of vaccine hesitancy indicators between those vaccinated and unvaccinated. Correlation to the hesitancy categories in other indicated vaccinations and associated factors need to be further investigated.
The authors declare that they have no competing interests.
The authors declare that a positive ethics committee vote has been obtained.
