Co-Administration of Influenza and COVID-19 Vaccines: Policy Review and Vaccination Coverage Trends in the European Union, UK, US, and Canada between 2019 and 2023

Abstract

Recommending co-administration of influenza and COVID-19 vaccines has emerged as a strategy to enhance vaccination coverage. This study describes the policy on co-administration and uptake of influenza and COVID-19 vaccination in Europe, the United Kingdom, the United States, and Canada between 2019 and 2023. We collected co-administration policy data from governmental websites, national health organizations, and newspapers. Influenza vaccination coverage among persons ≥65 years and COVID-19 vaccination coverage rates among persons ≥60 years or the general population were collected using national databases, the ECDC database, or ourworldindata.org between 2019 and 2023. Descriptive analyses were used. We collected data from 30/32 (94%) countries on vaccination policy in seasons 2021–2022 and 2022–2023, with most countries (25/30 to 30/30) having policies recommending co-administration. For influenza vaccination coverage, we collected data from 29/32 (91%, 2019–2020), 28/32 (88%, 2020–2021), 27/32 (84%, 2021–2022), and 6/32 (19%, 2022–2023) countries. COVID-19 vaccination was collected from 32/32 (2020–2021), 31/32 (97%, 2021–2022), and 24/32 (75%, 2022–2023) countries. Influenza vaccination coverage increased from 2019–2020 to 2021–2022. COVID-19 vaccination coverage was higher among countries with higher influenza vaccination coverage. By 2022–2023, all countries included implemented a policy supporting co-administration. A positive correlation existed between higher influenza vaccination coverage and higher COVID-19 vaccination rates.

Comparison of healthcare resource use and cost between influenza and COVID-19 vaccine coadministration and influenza vaccination only

“…When they calibrated using negative control outcomes, the observed association moved closer to the null and was no longer statistically significant. 13 Following favorable evidence from cohort study and clinical trials [14][15][16] on safety and immunogenicity, co-administration of influenza and COVID-19 vaccines on the same day have been recommended by most public authorities, 17 including the CDC. 5 The safety of coadministration strategy was further studied in a recent VAERS database analysis which concluded that co-administration of bivalent mRNA COVID-19 and seasonal influenza vaccines did not reveal any unusual or unexpected patterns of AEs.…”

Influenza Vaccine Uptake in Italy—The 2022–2023 Seasonal Influenza Vaccination Campaign in Italy: An Update from the OBVIOUS Project

“…Key findings demonstrate a suboptimal vaccination rate among adults, especially those with pre-existing health conditions [ 14 ]. Despite a general trend towards supporting the co-administration of COVID-19 and influenza vaccines, data show significant variability in vaccine coverage across different regions, with Eastern Europe lagging behind Western and Northern Europe and North America [ 15 ]. The studies also highlight the diverse approaches to vaccine recommendations across countries like Germany, Spain, the UK, and Italy, ranging from strict evidence-based criteria to more flexible real-world evidence considerations [ 16 ].…”