Impact of propensity to COVID-19 vaccination/vaccine on influenza vaccination from willingness to behavior among older adults in rural China.

To explore impact of the propensity to coronavirus disease 2019 (COVID-19) vaccine/vaccination on influenza vaccination from willingness to behavior after COVID-19 pandemic among older adults in rural China. A combined study involving a cross-sectional survey for the willingness of influenza vaccination, a health education momentary intervention and a community intervention program were conducted from September 11^th to 16^th, 2023 among rural older adults in China. Totally 3138 individuals were investigated in this study with 1923 (61.3%) willing to receive influenza vaccination. After the momentary intervention, 47.8% (582/1215) individuals changed to be willing to receive influenza vaccination. There were 1440 (78.8%) vaccinated. The influenza vaccination willingness rate was significantly higher in the participants willing to receive COVID-19 vaccine booster dose vaccination than the participants unwilling to (69.4% vs. 37.7%, adjusted OR [aOR] = 2.671, 95% CI 2.211-3.227, p < .001), as well as for the influenza vaccination willingness change rate (52.2% vs. 41.7%, aOR = 1.303, 95% CI 1.022-1.662, p < .05) and the influenza vaccination behavior rate (79.7% vs. 74.9%, aOR = 1.337, 95% CI 1.002-1.784, p < .05). The influenza vaccination behavior rate was significantly higher in those positive toward COVID-19 vaccine effectiveness or safety overall (80.0% vs. 74.9%, aOR = 1.394, 95% CI 1.065-1.823; 80.6% vs. 70.9%, aOR = 1.850, 95% CI 1.395-2.454; both p < .05). There was a positive impact of COVID-19 vaccine/vaccination on influenza vaccination from willingness to behavior among the older adults in rural China after COVID-19 pandemic, suggesting that integrating health education of related pathogens and vaccines might promote influenza vaccination.