Influenza vaccination uptake among Canadian adults before and during the COVID-19 pandemic: An analysis of the Canadian Longitudinal study on Aging (CLSA)

Giorgia Sulis; Nicole E. Basta; Christina Wolfson; Susan A. Kirkland; Jacqueline McMillan; Lauren E. Griffith; Parminder Raina

doi:10.1016/j.vaccine.2021.11.088

Influenza vaccination uptake among Canadian adults before and during the COVID-19 pandemic: An analysis of the Canadian Longitudinal study on Aging (CLSA)

Giorgia Sulis, Nicole E. Basta, Christina Wolfson, Susan A. Kirkland, Jacqueline McMillan, Lauren E. Griffith, Parminder Raina

Medicine

Research output: Contribution to journal › Article › peer-review

23 Citations (Scopus)

Abstract

Introduction: Understanding how influenza vaccine uptake changed during the 2020/2021 influenza season compared to previous pre-pandemic seasons is a key priority, as is identifying the relationship between prior influenza vaccination and COVID-19 vaccine willingness. Methods: We analyzed data from a large, nationally representative cohort of Canadian residents aged 50 and older to assess influenza vaccination status three times between 2015 and 2020. We investigated: 1) changes in self-reported influenza vaccine uptake, 2) predictors of influenza vaccine uptake in 2020/2021, and 3) the association between influenza vaccination history and self-reported COVID-19 vaccine willingness using logistic regression models. Results: Among 23,385 participants analyzed for aims 1–2, influenza vaccination increased over time: 14,114 (60.4%) in 2015–2018, 15,692 (67.1%) in 2019/2020, and 19,186 (82.0%; combining those already vaccinated and those planning to get a vaccine) in 2020/2021. After controlling for socio-demographics, history of influenza vaccination was most strongly associated with influenza vaccination in 2020/2021 (adjusted odds ratio [aOR] 147.9 [95% CI: 120.9–180.9]); this association remained after accounting for multiple health and pandemic-related factors (aOR 140.3 [95% CI: 114.5–171.8]). To a lesser degree, those more concerned about COVID-19 were also more likely to report influenza vaccination in fall 2020, whereas those reporting a very negative impact of the pandemic were less likely to get vaccinated. Among 23,819 participants with information on COVID-19 vaccine willingness during the last quarter of 2020 (aim 3), prior influenza vaccination was most strongly associated with willingness to get a COVID-19 vaccine (aOR 15.1 [95% CI: 13.5–16.8] for those who had received influenza vaccine at all previous timepoints versus none). Conclusions: Our analysis highlights the importance of previous vaccination in driving vaccination uptake and willingness. Efforts to increase vaccination coverage for influenza and COVID-19 should target individuals who do not routinely engage with immunization services regardless of demographic factors.

Original language	English
Pages (from-to)	503-511
Number of pages	9
Journal	Vaccine
Volume	40
Issue number	3
DOIs	https://doi.org/10.1016/j.vaccine.2021.11.088
Publication status	Published - Jan 24 2022

Bibliographical note

Funding Information:
Funding for the CLSA COVID-19 Questionnaire study was provided by Juravinski Research Institute, Faculty of Health Sciences, McMaster University, Provost Fund from McMaster University, McMaster Institute for Research on Aging, Public Health Agency of Canada and the Nova Scotia COVID-19 Health Research Funding Coalition. Funding for the Canadian Longitudinal Study on Aging (CLSA) is provided by the Government of Canada through the Canadian Institutes of Health Research (CIHR) under grant reference: LSA 94473 and the Canada Foundation for Innovation, as well as the following provinces: Newfoundland, Nova Scotia, Quebec, Ontario, Manitoba, Alberta, and British Columbia. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Funding Information:
This research has been conducted using the CLSA Baseline Data Version 3.7 (tracking cohort) and 5.2 (comprehensive cohort), CLSA follow up 1 Data Version 2.2 (tracking cohort) and 3.0 (comprehensive cohort), and CLSA COVID-19 Data Version 1. The CLSA is led by Drs. Parminder Raina, Christina Wolfson and Susan Kirkland. Parminder Raina holds the Raymond and Margaret Labarge Chair in Optimal Aging and Knowledge Application for Optimal Aging and Tier 1 Canada Research Chair in Geroscience. Lauren E. Griffith is supported by the McLaughlin Foundation Professorship in Population and Public Health. Nicole E. Basta is supported by a Tier 2 Canada Research Chair in Infectious Disease Prevention. Giorgia Sulis is supported by a grant from the National Institute of Allergy and Infectious Diseases of the US National Institutes of Health (NIH) (R01 AI132496 (PI: NEB.). The authors gratefully acknowledge key contribution from all members of the CLSA team: Andrew Costa, Laura Anderson, and Cynthia Balion (McMaster University); Asada Yukiko (Dalhousie University); Benoȋt Cossette and Melanie Levasseur (University of Sherbrooke); Scott Hofer and Theone Paterson (University of Victoria); David Hogan (University of Calgary); Teresa Liu-Ambrose (University of British Columbia); Verena Menec and Philip St. John (University of Manitoba); Gerald Mugford and Zhiwei Gao (Memorial University of Newfoundland); Vanessa Taler and Patrick Davidson (University of Ottawa); Andrew Wister and Theodore Cosco (Simon Fraser University).

Funding Information:
This research has been conducted using the CLSA Baseline Data Version 3.7 (tracking cohort) and 5.2 (comprehensive cohort), CLSA follow up 1 Data Version 2.2 (tracking cohort) and 3.0 (comprehensive cohort), and CLSA COVID-19 Data Version 1. The CLSA is led by Drs. Parminder Raina, Christina Wolfson and Susan Kirkland. Parminder Raina holds the Raymond and Margaret Labarge Chair in Optimal Aging and Knowledge Application for Optimal Aging and Tier 1 Canada Research Chair in Geroscience. Lauren E. Griffith is supported by the McLaughlin Foundation Professorship in Population and Public Health. Nicole E. Basta is supported by a Tier 2 Canada Research Chair in Infectious Disease Prevention. Giorgia Sulis is supported by a grant from the National Institute of Allergy and Infectious Diseases of the US National Institutes of Health (NIH) (R01 AI132496 (PI: NEB.). The authors gratefully acknowledge key contribution from all members of the CLSA team: Andrew Costa, Laura Anderson, and Cynthia Balion (McMaster University); Asada Yukiko (Dalhousie University); Beno?t Cossette and Melanie Levasseur (University of Sherbrooke); Scott Hofer and Theone Paterson (University of Victoria); David Hogan (University of Calgary); Teresa Liu-Ambrose (University of British Columbia); Verena Menec and Philip St. John (University of Manitoba); Gerald Mugford and Zhiwei Gao (Memorial University of Newfoundland); Vanessa Taler and Patrick Davidson (University of Ottawa); Andrew Wister and Theodore Cosco (Simon Fraser University).

Publisher Copyright:
© 2021 The Authors

ASJC Scopus Subject Areas

Molecular Medicine
General Immunology and Microbiology
General Veterinary
Public Health, Environmental and Occupational Health
Infectious Diseases

PubMed: MeSH publication types

Journal Article
Research Support, Non-U.S. Gov't

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.vaccine.2021.11.088

Cite this

@article{d0eeff5acd6d42a396601e1035aaf9fe,

title = "Influenza vaccination uptake among Canadian adults before and during the COVID-19 pandemic: An analysis of the Canadian Longitudinal study on Aging (CLSA)",

abstract = "Introduction: Understanding how influenza vaccine uptake changed during the 2020/2021 influenza season compared to previous pre-pandemic seasons is a key priority, as is identifying the relationship between prior influenza vaccination and COVID-19 vaccine willingness. Methods: We analyzed data from a large, nationally representative cohort of Canadian residents aged 50 and older to assess influenza vaccination status three times between 2015 and 2020. We investigated: 1) changes in self-reported influenza vaccine uptake, 2) predictors of influenza vaccine uptake in 2020/2021, and 3) the association between influenza vaccination history and self-reported COVID-19 vaccine willingness using logistic regression models. Results: Among 23,385 participants analyzed for aims 1–2, influenza vaccination increased over time: 14,114 (60.4%) in 2015–2018, 15,692 (67.1%) in 2019/2020, and 19,186 (82.0%; combining those already vaccinated and those planning to get a vaccine) in 2020/2021. After controlling for socio-demographics, history of influenza vaccination was most strongly associated with influenza vaccination in 2020/2021 (adjusted odds ratio [aOR] 147.9 [95% CI: 120.9–180.9]); this association remained after accounting for multiple health and pandemic-related factors (aOR 140.3 [95% CI: 114.5–171.8]). To a lesser degree, those more concerned about COVID-19 were also more likely to report influenza vaccination in fall 2020, whereas those reporting a very negative impact of the pandemic were less likely to get vaccinated. Among 23,819 participants with information on COVID-19 vaccine willingness during the last quarter of 2020 (aim 3), prior influenza vaccination was most strongly associated with willingness to get a COVID-19 vaccine (aOR 15.1 [95% CI: 13.5–16.8] for those who had received influenza vaccine at all previous timepoints versus none). Conclusions: Our analysis highlights the importance of previous vaccination in driving vaccination uptake and willingness. Efforts to increase vaccination coverage for influenza and COVID-19 should target individuals who do not routinely engage with immunization services regardless of demographic factors.",

author = "Giorgia Sulis and Basta, {Nicole E.} and Christina Wolfson and Kirkland, {Susan A.} and Jacqueline McMillan and Griffith, {Lauren E.} and Parminder Raina",

note = "Funding Information: Funding for the CLSA COVID-19 Questionnaire study was provided by Juravinski Research Institute, Faculty of Health Sciences, McMaster University, Provost Fund from McMaster University, McMaster Institute for Research on Aging, Public Health Agency of Canada and the Nova Scotia COVID-19 Health Research Funding Coalition. Funding for the Canadian Longitudinal Study on Aging (CLSA) is provided by the Government of Canada through the Canadian Institutes of Health Research (CIHR) under grant reference: LSA 94473 and the Canada Foundation for Innovation, as well as the following provinces: Newfoundland, Nova Scotia, Quebec, Ontario, Manitoba, Alberta, and British Columbia. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: This research has been conducted using the CLSA Baseline Data Version 3.7 (tracking cohort) and 5.2 (comprehensive cohort), CLSA follow up 1 Data Version 2.2 (tracking cohort) and 3.0 (comprehensive cohort), and CLSA COVID-19 Data Version 1. The CLSA is led by Drs. Parminder Raina, Christina Wolfson and Susan Kirkland. Parminder Raina holds the Raymond and Margaret Labarge Chair in Optimal Aging and Knowledge Application for Optimal Aging and Tier 1 Canada Research Chair in Geroscience. Lauren E. Griffith is supported by the McLaughlin Foundation Professorship in Population and Public Health. Nicole E. Basta is supported by a Tier 2 Canada Research Chair in Infectious Disease Prevention. Giorgia Sulis is supported by a grant from the National Institute of Allergy and Infectious Diseases of the US National Institutes of Health (NIH) (R01 AI132496 (PI: NEB.). The authors gratefully acknowledge key contribution from all members of the CLSA team: Andrew Costa, Laura Anderson, and Cynthia Balion (McMaster University); Asada Yukiko (Dalhousie University); Benoȋt Cossette and Melanie Levasseur (University of Sherbrooke); Scott Hofer and Theone Paterson (University of Victoria); David Hogan (University of Calgary); Teresa Liu-Ambrose (University of British Columbia); Verena Menec and Philip St. John (University of Manitoba); Gerald Mugford and Zhiwei Gao (Memorial University of Newfoundland); Vanessa Taler and Patrick Davidson (University of Ottawa); Andrew Wister and Theodore Cosco (Simon Fraser University). Funding Information: This research has been conducted using the CLSA Baseline Data Version 3.7 (tracking cohort) and 5.2 (comprehensive cohort), CLSA follow up 1 Data Version 2.2 (tracking cohort) and 3.0 (comprehensive cohort), and CLSA COVID-19 Data Version 1. The CLSA is led by Drs. Parminder Raina, Christina Wolfson and Susan Kirkland. Parminder Raina holds the Raymond and Margaret Labarge Chair in Optimal Aging and Knowledge Application for Optimal Aging and Tier 1 Canada Research Chair in Geroscience. Lauren E. Griffith is supported by the McLaughlin Foundation Professorship in Population and Public Health. Nicole E. Basta is supported by a Tier 2 Canada Research Chair in Infectious Disease Prevention. Giorgia Sulis is supported by a grant from the National Institute of Allergy and Infectious Diseases of the US National Institutes of Health (NIH) (R01 AI132496 (PI: NEB.). The authors gratefully acknowledge key contribution from all members of the CLSA team: Andrew Costa, Laura Anderson, and Cynthia Balion (McMaster University); Asada Yukiko (Dalhousie University); Beno?t Cossette and Melanie Levasseur (University of Sherbrooke); Scott Hofer and Theone Paterson (University of Victoria); David Hogan (University of Calgary); Teresa Liu-Ambrose (University of British Columbia); Verena Menec and Philip St. John (University of Manitoba); Gerald Mugford and Zhiwei Gao (Memorial University of Newfoundland); Vanessa Taler and Patrick Davidson (University of Ottawa); Andrew Wister and Theodore Cosco (Simon Fraser University). Publisher Copyright: {\textcopyright} 2021 The Authors",

year = "2022",

month = jan,

day = "24",

doi = "10.1016/j.vaccine.2021.11.088",

language = "English",

volume = "40",

pages = "503--511",

journal = "Vaccine",

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TY - JOUR

T1 - Influenza vaccination uptake among Canadian adults before and during the COVID-19 pandemic

T2 - An analysis of the Canadian Longitudinal study on Aging (CLSA)

AU - Sulis, Giorgia

AU - Basta, Nicole E.

AU - Wolfson, Christina

AU - Kirkland, Susan A.

AU - McMillan, Jacqueline

AU - Griffith, Lauren E.

AU - Raina, Parminder

N1 - Funding Information: Funding for the CLSA COVID-19 Questionnaire study was provided by Juravinski Research Institute, Faculty of Health Sciences, McMaster University, Provost Fund from McMaster University, McMaster Institute for Research on Aging, Public Health Agency of Canada and the Nova Scotia COVID-19 Health Research Funding Coalition. Funding for the Canadian Longitudinal Study on Aging (CLSA) is provided by the Government of Canada through the Canadian Institutes of Health Research (CIHR) under grant reference: LSA 94473 and the Canada Foundation for Innovation, as well as the following provinces: Newfoundland, Nova Scotia, Quebec, Ontario, Manitoba, Alberta, and British Columbia. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: This research has been conducted using the CLSA Baseline Data Version 3.7 (tracking cohort) and 5.2 (comprehensive cohort), CLSA follow up 1 Data Version 2.2 (tracking cohort) and 3.0 (comprehensive cohort), and CLSA COVID-19 Data Version 1. The CLSA is led by Drs. Parminder Raina, Christina Wolfson and Susan Kirkland. Parminder Raina holds the Raymond and Margaret Labarge Chair in Optimal Aging and Knowledge Application for Optimal Aging and Tier 1 Canada Research Chair in Geroscience. Lauren E. Griffith is supported by the McLaughlin Foundation Professorship in Population and Public Health. Nicole E. Basta is supported by a Tier 2 Canada Research Chair in Infectious Disease Prevention. Giorgia Sulis is supported by a grant from the National Institute of Allergy and Infectious Diseases of the US National Institutes of Health (NIH) (R01 AI132496 (PI: NEB.). The authors gratefully acknowledge key contribution from all members of the CLSA team: Andrew Costa, Laura Anderson, and Cynthia Balion (McMaster University); Asada Yukiko (Dalhousie University); Benoȋt Cossette and Melanie Levasseur (University of Sherbrooke); Scott Hofer and Theone Paterson (University of Victoria); David Hogan (University of Calgary); Teresa Liu-Ambrose (University of British Columbia); Verena Menec and Philip St. John (University of Manitoba); Gerald Mugford and Zhiwei Gao (Memorial University of Newfoundland); Vanessa Taler and Patrick Davidson (University of Ottawa); Andrew Wister and Theodore Cosco (Simon Fraser University). Funding Information: This research has been conducted using the CLSA Baseline Data Version 3.7 (tracking cohort) and 5.2 (comprehensive cohort), CLSA follow up 1 Data Version 2.2 (tracking cohort) and 3.0 (comprehensive cohort), and CLSA COVID-19 Data Version 1. The CLSA is led by Drs. Parminder Raina, Christina Wolfson and Susan Kirkland. Parminder Raina holds the Raymond and Margaret Labarge Chair in Optimal Aging and Knowledge Application for Optimal Aging and Tier 1 Canada Research Chair in Geroscience. Lauren E. Griffith is supported by the McLaughlin Foundation Professorship in Population and Public Health. Nicole E. Basta is supported by a Tier 2 Canada Research Chair in Infectious Disease Prevention. Giorgia Sulis is supported by a grant from the National Institute of Allergy and Infectious Diseases of the US National Institutes of Health (NIH) (R01 AI132496 (PI: NEB.). The authors gratefully acknowledge key contribution from all members of the CLSA team: Andrew Costa, Laura Anderson, and Cynthia Balion (McMaster University); Asada Yukiko (Dalhousie University); Beno?t Cossette and Melanie Levasseur (University of Sherbrooke); Scott Hofer and Theone Paterson (University of Victoria); David Hogan (University of Calgary); Teresa Liu-Ambrose (University of British Columbia); Verena Menec and Philip St. John (University of Manitoba); Gerald Mugford and Zhiwei Gao (Memorial University of Newfoundland); Vanessa Taler and Patrick Davidson (University of Ottawa); Andrew Wister and Theodore Cosco (Simon Fraser University). Publisher Copyright: © 2021 The Authors

PY - 2022/1/24

Y1 - 2022/1/24

N2 - Introduction: Understanding how influenza vaccine uptake changed during the 2020/2021 influenza season compared to previous pre-pandemic seasons is a key priority, as is identifying the relationship between prior influenza vaccination and COVID-19 vaccine willingness. Methods: We analyzed data from a large, nationally representative cohort of Canadian residents aged 50 and older to assess influenza vaccination status three times between 2015 and 2020. We investigated: 1) changes in self-reported influenza vaccine uptake, 2) predictors of influenza vaccine uptake in 2020/2021, and 3) the association between influenza vaccination history and self-reported COVID-19 vaccine willingness using logistic regression models. Results: Among 23,385 participants analyzed for aims 1–2, influenza vaccination increased over time: 14,114 (60.4%) in 2015–2018, 15,692 (67.1%) in 2019/2020, and 19,186 (82.0%; combining those already vaccinated and those planning to get a vaccine) in 2020/2021. After controlling for socio-demographics, history of influenza vaccination was most strongly associated with influenza vaccination in 2020/2021 (adjusted odds ratio [aOR] 147.9 [95% CI: 120.9–180.9]); this association remained after accounting for multiple health and pandemic-related factors (aOR 140.3 [95% CI: 114.5–171.8]). To a lesser degree, those more concerned about COVID-19 were also more likely to report influenza vaccination in fall 2020, whereas those reporting a very negative impact of the pandemic were less likely to get vaccinated. Among 23,819 participants with information on COVID-19 vaccine willingness during the last quarter of 2020 (aim 3), prior influenza vaccination was most strongly associated with willingness to get a COVID-19 vaccine (aOR 15.1 [95% CI: 13.5–16.8] for those who had received influenza vaccine at all previous timepoints versus none). Conclusions: Our analysis highlights the importance of previous vaccination in driving vaccination uptake and willingness. Efforts to increase vaccination coverage for influenza and COVID-19 should target individuals who do not routinely engage with immunization services regardless of demographic factors.

AB - Introduction: Understanding how influenza vaccine uptake changed during the 2020/2021 influenza season compared to previous pre-pandemic seasons is a key priority, as is identifying the relationship between prior influenza vaccination and COVID-19 vaccine willingness. Methods: We analyzed data from a large, nationally representative cohort of Canadian residents aged 50 and older to assess influenza vaccination status three times between 2015 and 2020. We investigated: 1) changes in self-reported influenza vaccine uptake, 2) predictors of influenza vaccine uptake in 2020/2021, and 3) the association between influenza vaccination history and self-reported COVID-19 vaccine willingness using logistic regression models. Results: Among 23,385 participants analyzed for aims 1–2, influenza vaccination increased over time: 14,114 (60.4%) in 2015–2018, 15,692 (67.1%) in 2019/2020, and 19,186 (82.0%; combining those already vaccinated and those planning to get a vaccine) in 2020/2021. After controlling for socio-demographics, history of influenza vaccination was most strongly associated with influenza vaccination in 2020/2021 (adjusted odds ratio [aOR] 147.9 [95% CI: 120.9–180.9]); this association remained after accounting for multiple health and pandemic-related factors (aOR 140.3 [95% CI: 114.5–171.8]). To a lesser degree, those more concerned about COVID-19 were also more likely to report influenza vaccination in fall 2020, whereas those reporting a very negative impact of the pandemic were less likely to get vaccinated. Among 23,819 participants with information on COVID-19 vaccine willingness during the last quarter of 2020 (aim 3), prior influenza vaccination was most strongly associated with willingness to get a COVID-19 vaccine (aOR 15.1 [95% CI: 13.5–16.8] for those who had received influenza vaccine at all previous timepoints versus none). Conclusions: Our analysis highlights the importance of previous vaccination in driving vaccination uptake and willingness. Efforts to increase vaccination coverage for influenza and COVID-19 should target individuals who do not routinely engage with immunization services regardless of demographic factors.

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Influenza vaccination uptake among Canadian adults before and during the COVID-19 pandemic: An analysis of the Canadian Longitudinal study on Aging (CLSA)

Abstract

Bibliographical note

ASJC Scopus Subject Areas

PubMed: MeSH publication types

UN SDGs

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