{
  "abstract": "Background: Influenza vaccination coverage in France remains suboptimal, with variability across population groups. We assessed demographic and behavioral determinants of influenza vaccination in the post-COVID-19 period among a primary care population in the Haute-Vienne department (Nouvelle-Aquitaine, France).\n\nMethods: We conducted a cross-sectional survey using an anonymous, self-administered questionnaire distributed to adults attending five general-practice sites between May and July 2023. The primary outcome was receipt of the 2022–2023 influenza vaccine. Candidate determinants included age, sex, municipality size, socio-professional category, eligibility criteria (age ≥ 65 years, healthcare-worker status, chronic conditions, or pregnancy), prior influenza vaccination, number of COVID-19 vaccine doses received, and self-reported history of influenza infection. Associations were examined using chi-square tests, Cochran–Armitage trend tests, and univariate logistic regression. Two multivariable logistic regression models were then constructed: a demographic model including age, sex, municipality size, socio-professional category, and the presence of any comorbidity or pregnancy, and a behavioral model including prior influenza vaccination and COVID-19 vaccination status (≥ 3 doses vs. ≤ 2 doses). Adjusted results were expressed as adjusted odds ratios (aOR) with 95% confidence intervals (95% CI).\n\nResults: Among the 800 questionnaires distributed, 432 were returned (participation rate: 54%). Overall, 75.9% of participants met at least one eligibility criterion for influenza vaccination. Influenza vaccination coverage for the 2022–2023 season was 58.3% and differed by municipality size (38.8% in areas with fewer than 5,000 inhabitants; 59.2% in those with 5,000–10,000; and 64.3% in those with more than 10,000, p = 0.0003) and increased with the regularity of prior influenza vaccination (6.7% among never vaccinated, 55.9% among occasional, and 96.6% among annually vaccinated, p < 0.0001). Coverage was also associated with the number of COVID-19 vaccine doses received (p < 0.0001). In the demographic model, age ≥ 65 years was associated with higher vaccination uptake (aOR 8.55, 95% CI 1.88–61.73, p = 0.012), whereas other demographic variables were not independently associated with vaccination uptake. In the behavioral model, prior influenza vaccination was strongly associated with vaccination uptake (aOR 16.20, 95% CI 7.21–36.41 for occasional vs. never and aOR 331.21, 95% CI 122.57–894.99 for annual vs. never; both p < 0.001). Receipt of ≥ 3 COVID-19 vaccine doses was also independently associated with vaccination uptake (aOR 2.64, 95% CI 1.01–6.89, p = 0.047).\n\nConclusions: In this primary care survey, influenza vaccination during the 2022–2023 season was primarily associated with prior influenza vaccination history, suggesting persistence of vaccination practices over time. Age ≥ 65 years and receipt of ≥ 3 COVID-19 vaccine doses were also independently associated with vaccination uptake, although to a lesser extent. Targeted strategies that reinforce continuity (annual reminders, vaccination offers during routine visits, and co-administration options) and encourage initiation among previously unvaccinated adults could help improve coverage.\n\nTrial registration: Not applicable.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28029-1.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Bacteriology, Virology and Hygiene, CHU Limoges, 2 avenue Martin Luther King, Limoges, 87042 France",
    "Beaublanc Primary Care Center, Limoges, France",
    "Department of Parasitology and Mycology, CHU Limoges, Limoges, France"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Sarah Mafi"
    },
    {
      "affs": [
        1
      ],
      "name": "Aurélien Billo"
    },
    {
      "affs": [
        2
      ],
      "name": "Marie-Fleur Durieux"
    },
    {
      "affs": [
        0
      ],
      "name": "Sébastien Hantz"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/227w8qr1fr2kx.bib",
  "cited_by": 1,
  "doi": "10.1186/s12889-026-28029-1",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13749655/",
  "id": "227w8qr1fr2kx",
  "issns": [
    "1471-2458"
  ],
  "landing_url": "https://doi.org/10.1186/s12889-026-28029-1",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "3306|Vaccine Coverage and Hesitancy"
    ]
  ],
  "openalex": "W7169770251",
  "pdf_url": null,
  "pmcid": "PMC13749655",
  "pmid": "42477617",
  "published": "2026-07-20",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/227w8qr1fr2kx.ris",
  "sources": [
    {
      "first_seen": "2026-11-14T12:22:23Z",
      "native_id": "PMC13749655",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12889-026-28029-1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:1471-2458",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Determinants of influenza vaccination in a French primary care population in the post-COVID-19 era",
  "title_text": "Determinants of influenza vaccination in a French primary care population in the post-COVID-19 era",
  "type": "peer-reviewed",
  "updated_at": "2026-11-14T12:22:23Z",
  "url": "https://research.draconitic.com/paper/227w8qr1fr2kx",
  "venue": "BMC Public Health",
  "versions": []
}