The COVID-19 pandemic led to an increase in flu vaccination coverage among children in Central Catalonia

The principal author of the research is pediatrician Sílvia Burgaya from the Manlleu Primary Care Team in Osona

A study conducted by the Central Catalonia Research Support Unit of IDIAPJGol and the Catalan Institute of Health concludes that the COVID-19 pandemic led to an increase in flu vaccination coverage among children in Central Catalonia. The research was authored by pediatrician Sílvia Burgaya from the Manlleu Primary Care Team in Osona and published in the European journal Vaccines. It is the only article published in Spain that analyzes how the COVID-19 pandemic influenced flu vaccination in children.

The study reviews flu vaccination coverage among children over five seasons (2018-2023) in Central Catalonia, analyzes the variables associated with flu vaccination in childhood, examines vaccination compliance in children with risk factors, and analyzes how the COVID-19 pandemic influenced in the pediatric population.

Until the 2022/23 season, only children with risk factors were vaccinated against the flu, but in this most recent 2023/24 season, all children under 5 years old have begun to receive flu vaccinations. This study, therefore, provides a baseline of data regarding flu vaccination coverage and compliance in children before the flu vaccine was incorporated into the routine childhood vaccination schedule.

The studied population consisted of children under 14 years old with risk factors between 2018 and 2023 in Central Catalonia, with data from the electronic database of the Catalan Institute of Health (ICS). A total of 13,137 children were studied, of whom 4,623 had received the flu vaccine at least once during a flu season. The average flu vaccination rate among children aged 6 months to 14 years with risk factors in Central Catalonia over the past 5 years was 28.8%. The highest vaccination coverage (36.96% and 28.55%) during the study period was in the 2020/21 and 2021/22 seasons, coinciding with the COVID-19 pandemic and “probably due to the similarity between flu and coronavirus symptoms and the fear this caused in families, as well as the promotion of flu vaccination during the COVID-19 pandemic for people with risk factors,” notes Sílvia Burgaya.

Dr. Sílvia Burgaya, a pediatrician at the Manlleu Primary Care Team and researcher at IDIAPJGol, principal author of the study

 

Children with asthma or diabetes were more vaccinated 

The statistically significant factors associated with vaccination were age—younger children are more likely to be vaccinated—and having certain risk factors: asthma, diabetes, hemoglobinopathies, and coagulation disorders. Conversely, heart diseases, celiac disease, and obesity were negatively associated with flu vaccination in nearly all seasons, meaning that patients with these three conditions were statistically significantly less vaccinated against the flu.

The research highlights “the importance of increasing flu vaccination rates and enhancing the recommendation for vaccination in the pediatric population to improve coverage and compliance with flu vaccination among children,” emphasizes pediatrician Sílvia Burgaya. She also explains that the data show that the immigrant pediatric population, both before and after the pandemic, was vaccinated more than the native population. These differences can be explained by cultural reasons and language barriers, according to the researcher. However, during the COVID-19 pandemic, the differences in flu vaccination between immigrant and native children disappeared, with native children being vaccinated at the same rate as immigrants. 

 

Significant Impact of Flu in Public Health 

Seasonal flu is a disease with a major impact on public health. The World Health Organization (WHO) estimates that the annual flu epidemic causes 1 billion infections, between 3 and 5 million cases of severe illness, and between 290,000 and 650,000 deaths. Children appear to be the most affected by this infection and are the primary carriers of the virus.

In Spain, it is estimated that there are 50,000 confirmed flu cases each year in primary care, 4,000 hospitalizations, 800 severe cases, 250 ICU admissions, and 8 in-hospital deaths of children under 5 years old. The highest accumulated incidence rate of flu in the last two seasons (2021/22-2022/23) was observed in the 0-4 age group, followed by the 5-14 age group. Hospitalizations for flu during the same period were highest among the elderly, followed by the 0-4 age group.

Vaccination is the best way to prevent flu. The Department of Health began flu vaccination for healthy children aged 6 months to 5 years with a single dose in the fall of 2023 in Catalonia. This age group not only suffers the most from the infection but can also experience severe complications from the disease, and the vaccine helps to protect children early from contracting the flu and its potential complications.

 

 

Article reference

Burgaya-Subirana S, Balaguer M, Miró Catalina Q, Sola L, Ruiz-Comellas A. Influenza Vaccination Coverage in Children: How Has COVID-19 Influenced It? A Review of Five Seasons (2018–2023) in Central Catalonia, Spain. Vaccines. 2024; 12(8):925. https://doi.org/10.3390/vaccines12080925