Influenza vaccination uptake and its determinants during the 2019-2020 and early 2020-2021 flu seasons among migrants in Shanghai, China: a cross-sectional survey

ABSTRACT

Influenza vaccination coverage has generally been low in mainland China. However, few studies have attempted to measure influenza vaccination coverage among internal migrants in China who are at an increased risk of influenza infections. This study assessed influenza vaccination coverage and the factors associated with vaccination uptake among internal migrants in Shanghai, China. We conducted a cross-sectional online survey among a sample of migrants residing in Shanghai during November 1–20, 2020, to investigate vaccination uptake during the 2019–20 and early 2020–21 flu seasons (September to November 2020). Multivariable logistic regression was used to examine the factors associated with influenza vaccination uptake for the two flu seasons. About a quarter, 26.3%, and 24.4% of respondents reported receiving an influenza vaccination during the 2019–20 and early 2020–2021 flu seasons, respectively. Respondents who were divorced or widowed, had more household members (2 or ≥ 3), and considered themselves in good health were more likely to receive an influenza vaccine, regardless of the season. Respondents who perceived that they were highly susceptible to influenza and COVID-19 and those who reported ever consulting a medical professional about COVID-19 were more likely to have received a flu vaccination in the early 2020–21 flu season. The uptake of influenza vaccination among internal migrants in Shanghai was suboptimal. We found a range of factors linked to influenza vaccination uptake, pointing to the need for more in-depth evaluations on the underlying reasons driving the vaccination uptake among vulnerable populations in China, especially during the COVID-19 pandemic.

KEYWORDS:

• Influenza
• COVID-19
• vaccine
• acceptance
• China

Acknowledgments

We are thankful to Qian Wang, Simeng Hu, Yuting Xing, Shujie Zang, Zhiqiang Qu, and Longfei Feng from School of Public Health, Fudan University for their help with data collection.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. The data used to support the findings of this study are available from the corresponding author upon request.

Informed consent statement

Informed consent was obtained from all subjects involved in the study. Written informed consent has been obtained from the patient(s) to publish this paper.

Institutional review board statement

This study was approved by Ethics Committee at the Fudan University School of Public Health [IRB#2020-12-0861].

Additional information

Funding

Zhiyuan Hou acknowledges financial support from the National Natural Science Foundation of China [No. 71874034], The National Key R&D Program of China [No. 2018YFC1312600 and 2018YFC1312604], and The National Institute for Health Research [EPIDZL9012] using UK aid from the UK Government to support global health research. The funders of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report.