The Influence of COVID-19 Pandemic on Influenza Immunization in Saudi Arabia: Cross-Sectional Study

Figures & data

Table 1 Descriptive Tables of Demographic Variables, N= Number of Participants, (n=2410)

Variable	Category	n (%)
Age	18–28	1120 (46.5)
	29–39	403 (16.7)
	40–50	559 (23.2)
	65–51	328 (13.6)
Gender	Female	1622 (67.3)
	Male	788 (32.7)
Marital Status	Single	1098 (45.6)
	Married	1176 (48.8)
	Widow	60 (2.5)
	Divorced	76 (3.2)
Nationality	Saudi	2287 (94.9)
	Non-Saudi	123 (5.1)
Education Level	High School	552 (22.9)
	Intermediate School	30 (1.2)
	Bachelor	1610 (66.8)
	Higher Education (Master’s/PhD)	218 (9.0)
Chronic Diseases	Diabetes Mellitus	189 (7.8)
	Thyroid Disease	123 (5.1)
	Cardiac Disease	41 (1.7)
	Hypertension	164 (6.8)
	CRD	68 (2.8)
	No chronic diseases	1825 (75.8)
Region	West	1006 (41.7)
	East	278 (11.5)
	North	91 (3.8)
	South	28 (1.2)
	Central	411 (17.0)

Table 2 Questions to Assess Knowledge, Practice, and Attitude Towards Influenza Vaccine During the COVID-19 Pandemic (Correct Answer Percentage)

Knowledge (K)	n (%)
K1. Have you heard about the flu vaccine	2305 (95.6)
K2. how often do you think the flu vaccine should be administered	1769 (73.4)
K3. Influenza is transmitted primarily by coughing and sneezing	2094 (86.9)
K4. Influenza is more severe than a “common cold.”	1284 (53.3)
K5. The signs and symptoms of influenza include fever, headache, sore throat, cough, nasal congestion, and aches and pains	2140 (88.8)
K6. People with influenza can transmit the infection only after their symptoms appear	830 (34.4)
K7. Influenza is transmitted primarily by contact with blood and body fluids	1077 (44.7)
K8. Influenza vaccination may not work if the vaccine contains the wrong mix of viruses	827 (34.3)
K9. Influenza vaccination does not work in some persons, even if the vaccine has the right mix of viruses	489 (20.3)
K10. Symptoms typically appear 8 to 10 days after a person is exposed to influenza	744 (30.9)
K11. The sign and symptoms of severe influenza include meningitis, pericarditis, pneumonia, otitis media	872 (36.2)
K12. Do you believe the COVID −19 vaccine will decrease the symptom of seasonal influenza?	686 (28.5)
Total Knowledge score, (mean±SD) (out of 12)	6.27±1.91
Practice (P)	n (%)
P1. Did you take the COVID-19 vaccine	2154 (89.4)
P2. Did you receive the influenza vaccine before COVID-19 started	947 (39.3)
P3. If you answered yes, how frequently did you take the flu vaccine?	481 (20)
Total Practice score, (mean±SD) (out of 3)	1.48±0.86
Attitude (A)	n (%)
A1. Do you believe the COVID-19 vaccine raises awareness of seasonal influenza	1353 (56.1)
A2. Do you feel the COVID-19 vaccine encourages you to take the influenza vaccine	650 (27)
A3. Do you believe the precaution measures for COVID-19 helped decrease the number of flu cases? (Face mask, wash hands frequently with soap and water, maintain distance)	2118 (87.9)
Total Attitude score, (mean±SD) (out of 3)	1.17±0.89

Abbreviations: K, Knowledge; P, Practice; A, Attitude; SD, Standard Deviation.

Table 3 Association of Demographic Characteristics of Participants and Knowledge, Practice, and Attitude Score (n=2410)

Variable	Category	Knowledge Score (Mean±SD)	Sig	Practice Score (Mean±SD)	Sig	Attitude Score (Mean±SD)	Sig
Age	18–28	6.45±1.87	<0.001**	1.44±0.85	<0.001**	1.66±0.86	<0.001**
	29–39	6.20±1.92		1.43±0.83		1.83±0.86
	40–50	6.11±193		1.51±0.88		1.74±0.93
	65–51	5.99±1.96		1.66±0.90		1.69±0.94
Gender	Female	7.27±1.90	0.62	1.41±0.85	<0.001**	1.64±0.88	<0.001**
	Male	6.25±.195		1.65±0.87		1.85±0.89
Marital Status	Widow	5.18±1.82	0.68	1.62±0.96	0.51	1.98±1.07	0.78
	Single	6.45±1.90		1.46±0.86		1.66±0.86
	Married	6.18±1.88		1.50±0.87		1.75±0.90
	Divorced	5.90±2.17		1.50±0.77		1.62±0.83
Nationality	Saudi	6.27±1.90	0.13	1.49±0.86	0.05*	1.71±0.89	0.31
	Non-Saudi	6.11±2.08		1.34±0.90		1.63±0.82
Education Level	Intermediate School	6.00±1.55	<0.001**	1.33±0.96	0.14	1.93±0.87	0.22
	High School	6.13±1.97		1.46±0.88		1.67±0.89
	Bachelor	6.28±1.89		1.49±0.85		1.74±0.88
	Higher Education (Master’s/PhD)	6.55±1.96		1.58±0.90		1.59±0.96
Chronic Diseases	Diabetes Mellitus	5.87±1.01	0.82	1.85±0.89	0.19	1.95±0.99	0.92
	Thyroid Disease	6.33±2.15		1.46±0.90		1.56±1.00
	Cardiac Disease	5.65±1.78		1.86±0.89		2.14±1.00
	Hypertension	5.11±2.01		1.46±0.87		1.73±0.93
	CRD	5.98±2.02		1.71±0.89		1.59±0.82
Region	West	6.10±1.91	0.04*	1.50±0.86	0.04*	1.81±0.90	<0.001**
	East	6.81±1.72		1.48±0.82		1.58±0.81
	North	5.80±1.87		1.09±0.82		1.48±0.93
	South	6.39±2.06		1.21±0.74		1.57±0.92
	Central	6.38±1.88		1.43±0.89		1.56±0.83

Notes: *P-value≤0.05, **P-value≤0.001.

Abbreviation: SD, Standard Deviation.

Figure 1 Impacts of COVID-19 pandemic on the influenza vaccination in Saudi Arabia. **P-value≤0.001.

Abbreviations: OR, Odds Ratio; CI, Confidence interval; Sig, Significance.