Association between Covid-19 Related Distress and Uptake of Influenza and Covid-19 Vaccines: A Cross-Sectional Study

Abstract

Introduction: It is well-known that exposure to significant distress such as the current pandemic and the restrictions that accompanied it, can be associated with negative psychological effects and adoption of new protective behaviors. Moreover, influenza vaccination uptake had always been lower than 50% in the U.S. This research aims to describe an association between the COVID-19-related distress and increase in the influenza vaccine uptake. Methods: This is a cross-sectional study of 201 respondents. An online self-administered questionnaire was distributed between January 2021-March 2021. The COVID-19 psychosocial and practical experience scales from the university of Miami were used to assess sample distress. The primary outcome was uptake of influenza vaccine. The secondary outcome was uptake of COVID-19/ and or intention to receive COVID-19 vaccine. An open-ended question was used to assess barriers and facilitators of vaccination in general. Basic statistics were computed, and bivariate and multivariate logistic regression analyses were used to describe the vaccine uptake associations. Content analysis was used for the qualitative analysis of the open-ended question. Results: COVID-19 specific distress (Emotional and Physical Reactions), OR: 2.15, 95% CI: 1.17 – 3.95, financial hardship OR: 6, 95% CI: 1.32 – 26, prior influenza vaccination, OR: 125, 95% CI: 25 – 630 and uptake of COVID-19 vaccine, OR: 26.72, 95% CI: 4 – 196 were significantly associated with uptake of influenza vaccine. As for the uptake of COVID-19 vaccine, it was associated with prior influenza vaccination, OR: 5.22, 95% CI: 1.9 – 14.2, perceived benefits, OR: 0.56, 95% CI: 0.32- 0.98, and perceived stress management, OR: 3.48, 95% CI: 1.38 – 8.80. Finally, the most common barriers to vaccination in general were concerns about safety and side effects, access and availability, lack of trust in the healthcare system. While the facilitators were prevention, protection, and care on the individual, community, and societal levels. Conclusion: In conclusion, focusing on multi-level interventions to promote vaccination is the cornerstone for successful distribution and uptake of vaccines. Understanding the specific type of distress related to the COVID-19 pandemic that is deriving vaccination uptake is an important step to identify the impact of pandemic distress and deepen understanding of behavior towards vaccination for future interventions that address uptake of vaccination.