Differences in Attitudes Toward COVID-19 and Influenza Vaccines Revealed by Hesitancy Trends

Health care worker holding a vaccine needle.

(Adobe Stock 410673389 by Aron M - Austria)

As we start 2024, it’s hard not to look back and consider our actions and responses to the public health COVID-19 crisis we’ve lived through over the last few years. Of the many things we continue to face in public health is how to improve vaccine uptake and attitudes towards these critical tools.

To begin, consider influenza and COVID-19 incidence rates in the United States this past year. There have been 7.1-14 million influenza illnesses, 3.2-6.5 million influenza (flu) medical visits, 73,000-150,000 flu hospitalizations, and 4500-13,000 deaths.¹

According to the CDC, test positivity in the United States is 12.7%, and 2.5% of emergency department visits are diagnosed as COVID-19.

In the week before Christmas 2023, over 29,000 hospitalizations were due to COVID-19, underscoring the increase in disease transmission and severity.² The CDC also reported over 7090 hospital admissions for influenza for the week that ended December 9, 2023, up from 5816 admissions the week ending December 2.

These statistics are concerning because both respiratory viruses are seeing an increase in incidence rates. According to a new survey, safety beliefs about COVID-19 vaccines may lead to lower immunization uptake, potentially exacerbating the problem.

Specifically, the survey was developed into a new research study published in JAMA, which assessed vaccine attitudes towards COVID-19 versus influenza.³ The authors take care to note that in the post-emergency pandemic state of COVID-19, attitudes have shifted and that ensuring adults continue to get vaccinated requires understanding various pieces, such as perception of annual vaccine schedules, coadministration, and communication.

Using data from a national survey of adults administered July 7 to 16, 2023, researchers could better understand attitudes towards these two vaccines. This survey looked at adult vaccine attitudes but differentiated in those 50 and older, as such individuals may have a higher risk for severe disease. The survey ultimately reached and returned results for 1430 adults (a 44% return rate), and attitudes included effectiveness and safety, vaccination intentions, and dug into hesitancy.

The authors of the study reported that respondents claimed that “nearly equal shares said that COVID-19 vaccines (42%) and influenza vaccines (40%) are very effective at protecting against serious illness or hospitalization (all percentages are weighted). Views diverged on vaccine safety, where a higher share said influenza vaccines are safer than COVID-19 vaccines (55% vs 41%). Similarly, intentions differed: 49% said they are very likely to get an influenza vaccine this season, compared with 36% saying the same for an updated COVID-19 vaccine. Patterns were similar among adults aged 50 years and older. Among more hesitant adults (less likely to get vaccinated), concerns about updated COVID-19 and influenza vaccines differed.”³

Hesitancy surrounded the COVID-19 vaccine more, with responses citing a need for more research, worries about safety and efficacy, and that there was already substantial individual immunity from previous infections or vaccination. Interestingly, individuals reported distrusting government agencies and vaccine development companies for COVID-19 despite the same being used to promote influenza shots.

Ultimately, there were many reasons for hesitancy, and this cross-sectional study shared some important, interesting, self-reported findings that can be used to drive more focused education. As we move further away from the COVID-19 emergency state, it will be important to address hesitancy and rebuild trust in science, policy, and response.

REFERENCES

1. 2023-2024 U.S. Flu Season: Preliminary In-Season Burden Estimates. CDC. Accessed December 29, 2023. https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm

2. COVID Data Tracker. CDC. Accessed December 23, 2023. https://covid.cdc.gov/covid-data-tracker/#datatracker-home

3. Steelfisher GK, Findling MG, Caporello HL, McGowan E, Espino L, Sutton J. Divergent Attitudes Toward COVID-19 Vaccine vs Influenza Vaccine. JAMA Netw Open. 2023;6(12):e2349881. doi:10.1001/jamanetworkopen.2023.49881