Determinants of influenza vaccination in a French primary care population in the post-COVID-19 era

@article{mafi2026determinants,
  title = {{Determinants of influenza vaccination in a French primary care population in the post-COVID-19 era}},
  author = {Sarah Mafi and Aurélien Billo and Marie-Fleur Durieux and Sébastien Hantz},
  journal = {BMC Public Health},
  year = {2026},
  month = jul,
  doi = {10.1186/s12889-026-28029-1},
  url = {https://doi.org/10.1186/s12889-026-28029-1},
  note = {CC BY-NC-ND 4.0},
}

TY  - JOUR
TI  - Determinants of influenza vaccination in a French primary care population in the post-COVID-19 era
AU  - Sarah Mafi
AU  - Aurélien Billo
AU  - Marie-Fleur Durieux
AU  - Sébastien Hantz
PY  - 2026
DA  - 2026/07/20
JO  - BMC Public Health
DO  - 10.1186/s12889-026-28029-1
UR  - https://doi.org/10.1186/s12889-026-28029-1
AB  - 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).  Methods: 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).  Results: 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).  Conclusions: 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.  Trial registration: Not applicable.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28029-1.
SN  - 1471-2458
ER  -