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Vaccine Mandates and Influenza Vaccination During the Pandemic

Claire Abraham1,2,3, Laura F Garabedian3, Robert F LeCates3

  • 1Division of General Pediatrics, Harvard Medical School, Boston, Massachusetts.

Pediatrics
|October 10, 2023
PubMed

Insights

A state influenza vaccine mandate increased childhood vaccination rates. However, high community COVID-19 severity decreased vaccination probability for previously vaccinated children.

Area of Science:

  • Pediatric infectious disease epidemiology
  • Public health policy impact on vaccination

Background:

  • Understanding factors influencing childhood influenza vaccination is crucial for public health.
  • The 2020-2021 influenza season occurred during the COVID-19 pandemic, introducing unique challenges and policy considerations.

Purpose of the Study:

  • To assess the impact of a state influenza vaccine mandate on pediatric influenza vaccination.
  • To evaluate the effect of community coronavirus disease 2019 (COVID-19) severity on childhood influenza vaccine uptake.
  • To examine how previous vaccination history modifies these effects.

Main Methods:

  • Longitudinal cohort study of 71,333 children (6 months–18 years) using insurance claims data.
  • Analysis of data from Massachusetts, New Hampshire, and Maine during the 2020-2021 influenza season.
  • Linking county-level COVID-19 case data to individual vaccination records.

Main Results:

  • Children in a state with an influenza vaccine mandate had significantly higher vaccination probabilities, especially previous non-vaccinators.
  • Previously vaccinated children in high COVID-19 severity counties showed a lower probability of receiving the influenza vaccine.
  • Mandates showed a positive impact, while high community COVID-19 burden presented a barrier for some children.

Conclusions:

  • Influenza vaccination strategies should consider individual vaccination history.
  • Community-level factors, such as pandemic severity, play a role in vaccine uptake.
  • Tailored approaches are necessary to optimize influenza vaccination coverage in children.
Abstract

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