Impact of COVID-19 pandemic on influenza vaccine uptake

Dear Editor, International guidelines advocate the administration of annual influenza vaccination, especially to high-risk groups. Unfortunately, the acceptance of influenza vaccine has remained abysmally low. We did a retrospective analysis using the hospital medical records to examine whether the advent of the COVID-19 pandemic and the introduction of the COVID vaccine had any impact on the uptake of the influenza vaccine. We analysed the data of all adult patients who were administered the influenza vaccine from 2017 till 2023 from the hospital pharmacy [Figure 1]. From 2017 to 2021, the number of units of vaccines dispensed was 3820, 3884, 4132, 4192, and 4772, respectively (mean = 4160). In the year 2022, the number of units of vaccines dispensed was 9165 units, which was nearly double that of the previous year. In 2023, 10850 units of influenza vaccine were dispensed from the hospital pharmacy, which indicates that the graph is still showing an upward trend.Figure 1: Graph showing the influenza vaccination trend from 2017 to 2023The reasons for increased uptake of influenza vaccine during the postpandemic period could be many. There has been an increased awareness amongst the public about vaccine-preventable respiratory diseases. There is a school of thought that the influenza vaccine might provide cross-immunity against COVID-19.[1] Reports of fear of likely the emergence of the "Tripledemic" (COVID, influenza and RSV) could also have contributed to a higher uptake.[2] Our findings are in stark contrast to the observations of Leutcher et al., who have documented a decrease in influenza vaccination trends in their centre.[3] In their meta-analysis, Kong et al., have shown that there is a trend towards increased acceptance of the influenza vaccine, after the emergence of the COVID-19 pandemic, which is similar to what we have observed.[4] This increased intention to vaccinate against influenza in the aftermath of the COVID-19 pandemic is indeed a very encouraging trend. This is despite the fact that in our country, unlike in some countries in Europe and the USA, vaccine is not given free of cost, and it involves out-of-pocket expenses. Our institute is situated in Trivandrum, the capital city of the southernmost state of Kerala, a state which boasts 100% literacy of its population. Perhaps this high literacy level could also have contributed to the increased vaccine acceptance. This study was conducted in a tertiary care centre, where affordability might not have mattered much. More such studies from other parts of the country and other parts of the world would be needed to validate our observations. Also, if the vaccines are made available either free or at a much-subsidized price, the acceptance rate may go up even higher. This in turn would reduce health care spending, as influenza vaccination with its known effectiveness of 45–55% would reduce the severity of illness, reduce hospitalization and also the chance of developing severe forms of the disease like ARDS. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.