OBJECTIVES : The 2020/21 influenza season was marked by the co-circulation of the Sars-CoV-2 responsible for the COVID-19 pandemic, and strong incentives supporting influenza vaccination were issued by governments to protect their populations. The objective of this study was to assess the evolution of influenza vaccine coverage rate (VCR) under the COVID-19 pandemic.

METHODS : We conducted secondary desk research to collect annual influenza VCR for the seasons 2010/11 to 2020/21 in France, Italy, Spain, UK, Canada and US. Government and public health agency websites were consulted and VCR were extracted for all populations eligible to influenza vaccination. Stakeholders were contacted by email when information was not available. We used non-parametric Wilcoxon signed-rank tests to investigate significant variations in VCR per eligible group for the 2020/21 season compared to previous seasons.

RESULTS : VCRs for the 2020/21 season were not available for Italy and Spain, and VCRs for Canada were only available from the season 2015/16 onwards. Overall VCR in France increased by 15.58% in 2020/21 compared to previous seasons (p=0.001). Significant increases in VCR in both adults aged 65+ years and below 65 years at-risk were observed in France (+15.55% / +11.60% ; all p=0.001 ) and the UK (+10.89% / +7.68% ; all p=0.001). In the US where influenza immunization is recommended for all individuals aged 6 months and above, significant increases in VCR were noted for the 2020/21 season in the following age groups: 18+ years (+39.69%), 18-49 years (+57.52%), 50-64 years (+36.30%) and 65+ years (+14.86%) (all p=0.001). No significant changes were observed for all eligible groups in Canada.

CONCLUSIONS : Significant augmentations in influenza VCR were observed during the 2020/21 season, probably in reaction to the COVID-19 pandemic. Analyses for Italy and Spain should be conducted once data is available and surveillance of VCR should be pursued as the pandemic is still ongoing.