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Accepted for/Published in: JMIR Public Health and Surveillance

Date Submitted: May 17, 2024
Date Accepted: Dec 5, 2024

The final, peer-reviewed published version of this preprint can be found here:

Influenza Vaccination Coverage and Determinants of New Vaccinations During the COVID-19 Pandemic in Spain (ENE-COVID): Nationwide Population-Based Study

de la Cámara M, Fernández de Larrea-Baz N, Pastor-Barriuso R, Larrauri A, Fernández-Navarro P, Pollán M, Pérez-Gómez B, ENE-COVID Study Group

Influenza Vaccination Coverage and Determinants of New Vaccinations During the COVID-19 Pandemic in Spain (ENE-COVID): Nationwide Population-Based Study

JMIR Public Health Surveill 2025;11:e60658

DOI: 10.2196/60658

PMID: 40591528

PMCID: 12236637

Influenza vaccination coverage and determinants of new vaccinations during the COVID-19 pandemic in Spain: the ENE-COVID nationwide population-based study

  • Miguel Ángel de la Cámara; 
  • Nerea Fernández de Larrea-Baz; 
  • Roberto Pastor-Barriuso; 
  • Amparo Larrauri; 
  • Pablo Fernández-Navarro; 
  • Marina Pollán; 
  • Beatriz Pérez-Gómez; 
  • ENE-COVID Study Group

ABSTRACT

Background:

Influenza vaccination coverage is commonly suboptimal. However, the COVID-19 pandemic and consequent high exposure to health information may have changed population attitudes towards this vaccination.

Objective:

To describe influenza vaccine uptake in Spain during the first influenza season following the start of the COVID-19 pandemic compared to the previous one, and characteristics associated with vaccination among those previously unvaccinated.

Methods:

Population-based study including 28,987 adult people from influenza vaccination target groups (≥65 years old, with risk conditions, living with someone with risk conditions, healthcare workers, security/emergency workers) participants in the nationwide ENE-COVID seroepidemiological survey. Information on vaccination and sociodemographic, health and COVID-19 related factors was collected by interview. Coverage change from 2019 to 2020 and standardized prevalences of new vaccination were estimated using logistic model-based methods.

Results:

Coverage rose from 31.4% [95% CI: 30.5-32.2] to 46.8% [45.8-47.8]. People ≥65 years old showed the highest uptake in both periods (58.3% [56.8-59.8] to 74.8% [73.5-76.1]), while healthcare workers had the greatest increase (22.0% [17.8-26.2]). Among people unvaccinated in 2019, factors associated with vaccination in 2020 were: age, female sex, higher education, Spanish nationality, multimorbidity, being ex-smoker, obesity, contact with COVID-19 cases, living with elder people, in provinces with low COVID-19 incidence, wearing facemask during family meetings, and using surgical/FFP2 masks.

Conclusions:

This study provides nationwide representative estimates of influenza vaccination coverage, which clearly increased between 2019 and 2020 in the five target groups. However, coverage goals were attained only in the ≥65 years old group, highlighting the importance of reinforcing influenza vaccination. Our detailed results on determinants of vaccination provide some clues to tailor vaccination strategies.


 Citation

Please cite as:

de la Cámara M, Fernández de Larrea-Baz N, Pastor-Barriuso R, Larrauri A, Fernández-Navarro P, Pollán M, Pérez-Gómez B, ENE-COVID Study Group

Influenza Vaccination Coverage and Determinants of New Vaccinations During the COVID-19 Pandemic in Spain (ENE-COVID): Nationwide Population-Based Study

JMIR Public Health Surveill 2025;11:e60658

DOI: 10.2196/60658

PMID: 40591528

PMCID: 12236637

Per the author's request the PDF is not available.

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