tetano
Editor, Senior Moderator
PLoS One
. 2025 Jun 17;20(6):e0326098.
doi: 10.1371/journal.pone.0326098. eCollection 2025. Vaccine fatigue and influenza vaccination trends across Pre-, Peri-, and Post-COVID-19 periods in the United States using epic's cosmos database
Tyler B Nofzinger[SUP] 1 2 [/SUP], Timothy T Huang[SUP] 1 2 [/SUP], Christopher Eduard R Lingat[SUP] 1 2 [/SUP], Gaurang M Amonkar[SUP] 1 2 [/SUP], Emily E Edwards[SUP] 1 2 [/SUP], Albert Yu[SUP] 1 3 [/SUP], Alexander D Smith[SUP] 1 4 [/SUP], Nasser Gayed[SUP] 1 [/SUP], Heidi L Gaddey[SUP] 1 2 [/SUP]
Affiliations
Introduction: Influenza vaccination is a critical public health measure, especially amidst the challenges of the COVID-19 pandemic. This study uses Epic's Cosmos database to analyze influenza vaccination trends across demographic groups in the United States, examining the effects of the COVID-19 pandemic and "vaccine fatigue" on influenza vaccination rates.
Methods: This retrospective cross-sectional study analyzes influenza vaccination rates pre- (1 May 2018-31 May 2019), peri- (1 May 2020-31 May 2021), and post-COVID-19 (1 May 2023-31 May 2024). A two-proportion z-test and Cohen's h test were calculated to assess statistical significance.
Results: Influenza vaccination rates increased peri-COVID (+1.99% point change, h = 0.04, p < 0.001) and decreased post-COVID (-6.41% point change, h = 0.14, p < 0.001) relative to pre-COVID. The largest changes were observed in the following groups: 5-18 year olds (-13.92% point change, h = 0.31, p < 0.001), 19-26 year olds (-9.91% point change, h = 0.25, p < 0.001), American Indian or Alaska Native (-8.11% point change, h = 0.18, p < 0.001), Other Races (-7.36% point change, h = 0.17, p < 0.001), White (-6.89% point change, h = 0.15, p < 0.001), and the South U.S. census region (-7.21% point change, h = 0.17, p < 0.001).
Conclusion: Post-pandemic influenza vaccination compliance decreased relative to pre-pandemic, especially among younger age groups, certain racial groups, and in the southern U.S. These findings suggest that the COVID-19 pandemic negatively impacted influenza vaccination compliance. While overall trends aligned with publicly available data, absolute counts may be under-reported within Epic due to incomplete documentation of vaccine administrations outside of Epic-affiliated systems.
. 2025 Jun 17;20(6):e0326098.
doi: 10.1371/journal.pone.0326098. eCollection 2025. Vaccine fatigue and influenza vaccination trends across Pre-, Peri-, and Post-COVID-19 periods in the United States using epic's cosmos database
Tyler B Nofzinger[SUP] 1 2 [/SUP], Timothy T Huang[SUP] 1 2 [/SUP], Christopher Eduard R Lingat[SUP] 1 2 [/SUP], Gaurang M Amonkar[SUP] 1 2 [/SUP], Emily E Edwards[SUP] 1 2 [/SUP], Albert Yu[SUP] 1 3 [/SUP], Alexander D Smith[SUP] 1 4 [/SUP], Nasser Gayed[SUP] 1 [/SUP], Heidi L Gaddey[SUP] 1 2 [/SUP]
Affiliations
- PMID: 40526617
- DOI: 10.1371/journal.pone.0326098
Introduction: Influenza vaccination is a critical public health measure, especially amidst the challenges of the COVID-19 pandemic. This study uses Epic's Cosmos database to analyze influenza vaccination trends across demographic groups in the United States, examining the effects of the COVID-19 pandemic and "vaccine fatigue" on influenza vaccination rates.
Methods: This retrospective cross-sectional study analyzes influenza vaccination rates pre- (1 May 2018-31 May 2019), peri- (1 May 2020-31 May 2021), and post-COVID-19 (1 May 2023-31 May 2024). A two-proportion z-test and Cohen's h test were calculated to assess statistical significance.
Results: Influenza vaccination rates increased peri-COVID (+1.99% point change, h = 0.04, p < 0.001) and decreased post-COVID (-6.41% point change, h = 0.14, p < 0.001) relative to pre-COVID. The largest changes were observed in the following groups: 5-18 year olds (-13.92% point change, h = 0.31, p < 0.001), 19-26 year olds (-9.91% point change, h = 0.25, p < 0.001), American Indian or Alaska Native (-8.11% point change, h = 0.18, p < 0.001), Other Races (-7.36% point change, h = 0.17, p < 0.001), White (-6.89% point change, h = 0.15, p < 0.001), and the South U.S. census region (-7.21% point change, h = 0.17, p < 0.001).
Conclusion: Post-pandemic influenza vaccination compliance decreased relative to pre-pandemic, especially among younger age groups, certain racial groups, and in the southern U.S. These findings suggest that the COVID-19 pandemic negatively impacted influenza vaccination compliance. While overall trends aligned with publicly available data, absolute counts may be under-reported within Epic due to incomplete documentation of vaccine administrations outside of Epic-affiliated systems.