Flu Shot Study Offers Window Into Coronavirus Vaccine Uptake in U.S.

A study looking at which groups of people are least likely to get the flu shot, and which states have the lowest adoption rates, could provide an insight into how a coronavirus vaccine will be adopted across the U.S., a team of scientists have said.

A Gallup poll published August 7 showed that if an FDA approved free COVID-19 vaccine were ready today, 35 percent said they would not have it. Support was lowest among Republicans, with just 47 percent saying they would get vaccinated under these circumstances. Non-white Americans, those from rural areas and those aged between 50 and 64 were all found to be most reluctant to the hypothetical vaccine.

Concerns have been raised about the potentially low uptake of a future vaccine. Recent research based on computer simulations suggests that in order to stop the pandemic, 75 percent of Americans will need to get vaccinated, and that vaccine must be at least 80 percent efficient. In June, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and coronavirus task force member, warned that "anti-science bias" in the U.S. may cause problems for a future vaccination campaign against COVID-19.

In a study published in the Journal of General Internal Medicine, a team of researchers from the U.S. have looked at uptake of the influenza vaccine based on demographic data.

Texas has the lowest uptake of the seasonal flu vaccine of all U.S. states, with Louisiana, New York, Indiana and Tennessee all coming in below 29 percent. This is in contrast to the highest adoption, with Washington D.C. coming out top and West Virginia, North Carolina, Iowa and Pennsylvania all having uptake above 40 percent.

Young adults and those without insurance were least likely to get the vaccine. People without a personal doctor also had a lower uptake. Black and Hispanic people were less likely than white and Asians to have the shot, and men were less likely than women to get vaccinated.

All these factors, the team say, could inform how a COVID-19 vaccine will be viewed by different members of society across the U.S.

"Our influenza vaccine data show that a vaccine that is voluntary and costs the patient money may get low uptake," study authors Brandon Yan, from the University of California San Francisco, and Professor R. Adams Dudley, from the University of Minnesota, told Newsweek in an email. " If COVID vaccine policies are the same, then we should expect similar behaviors and differences, with those who have to pay opting out. So a decision for government leaders, insurers, and employers is whether to make people pay or offer the vaccine for free."

They said there was some good news from their data. Older people and those with chronic conditions—groups who are at higher risk of the flu—had higher rates of vaccination. But there were downsides too, they said, pointing to the low uptake among Black and Native American patients.

Dudley and Yan said that generally they expect people who are reluctant to get the flu shot to approach a coronavirus vaccine in the same way. "However, the public's concern and anxiety over COVID-19 the disease far exceeds that of influenza, which may motivate more people to get the COVID-19 vaccine. In addition, the disparities in influenza vaccine coverage that we attribute to differences in health care access, regular utilization of care, and trust in the health care system remain systemic issues of health equity that we unfortunately expect to repeat itself with the COVID-19 vaccine if no interventions are undertaken."

They believe that initially, there will be high uptake of the vaccine, with demand probably outweighing supply. The impact of anti-vaccination attitudes is unlikely to be seen until the first adopters have all been served.

"What we don't know, though, is what percent of the population that will be and—most importantly—whether it will be enough to reach herd immunity, where the virus gets stopped because when it tries to spread usually just bounces off immune people," Yan and Dudley said.

"This season's influenza vaccination will serve as a dry-run for when the COVID-19 vaccine becomes available. We will be looking for how many get people get vaccinated, where they get vaccinated, and the reasons why some people did not get vaccinated to understand what an effective outreach strategy would be for the COVID-19 vaccine.

"The health equity concerns raised by existing disparities in influenza vaccination will likely repeat themselves with the COVID-19 vaccine without urgent intervention and planning."

Stock image representing a vaccine. Researchers looked at flu shot uptake in the U.S. and how this may inform adoption of any future coronavirus vaccine. iStock