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NPJ Vaccines . Spillover between influenza and COVID-19 vaccination behaviors across pandemic phases and implications for general vaccine hesitancy

tetano

Editor, Senior Moderator
NPJ Vaccines


. 2026 Feb 16.
doi: 10.1038/s41541-026-01398-9. Online ahead of print.
Spillover between influenza and COVID-19 vaccination behaviors across pandemic phases and implications for general vaccine hesitancy

Sitong Luo[SUP] 1 [/SUP], Siwen Huang[SUP] 1 [/SUP], Edmund W J Lee[SUP] 2 [/SUP], Hui Jiang[SUP] 3 [/SUP], Luyao Xie[SUP] 4 [/SUP], Xinchen Ye[SUP] 4 [/SUP], Ho Hin Lee[SUP] 4 [/SUP], Kam Hei Hui[SUP] 5 [/SUP], Phoenix K H Mo[SUP] 6 [/SUP], Meiqi Xin[SUP] 7 [/SUP]


Affiliations
Free article Abstract

Achieving high vaccination coverage is a critical challenge during both crisis and routine outbreaks of infectious diseases. Previous studies have largely focused on single vaccination behaviors and vaccine-specific attitudes. A three-wave prospective longitudinal study was conducted to investigate the complex relationships between influenza vaccination behavior, COVID-19 vaccination behavior, and general vaccine hesitancy across different peri-pandemic phases. Uptake of pre-pandemic influenza vaccination was associated with uptake of full COVID-19 vaccination during the outbreak of COVID-19, which was further associated with uptake of influenza vaccination in the post-emergency phase when a strong resurgence of seasonal influenza occurred. The specific vaccination behaviors and negative general attitudes toward vaccination had reciprocal relationships across the peri-pandemic phases. Reduced negative attitudes toward vaccination mediated the spillover between influenza and COVID-19 vaccination behaviors. This suggests that general vaccine hesitancy could have a profound impact on shaping specific vaccination behaviors across target diseases and risk communication contexts. Two-tier promotion strategies can help effectively promote vaccinations and better prepare for future pandemics.


 
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