Socioeconomic disparities in influenza vaccination uptake: impact of the COVID-19 pandemic in South Korea

BMC Public Health. 2025 Jan 6;25(1):42. doi: 10.1186/s12889-024-21254-6.

Abstract

Background: This study aimed to investigate the sociodemographic and behavioral factors related to increased influenza vaccination uptake during the COVID-19 pandemic in South Korea, particularly among adults not eligible for free vaccination.

Methods: Analyzing data from 78,815 participants in the Korea National Health and Nutrition Examination Survey (2010-2021), we assessed trends in influenza vaccination coverage. Various sociodemographic factors, behavioral aspects, and psychological stress levels were assessed using multivariable logistic regression to evaluate the difference in vaccination response during pre-/post-COVID-19 periods.

Results: Lowest income quartile households exhibited decreased influenza vaccination uptake during the pandemic (adjusted odds ratio 0.67, p = 0.011), whereas higher income quartiles exhibited increased uptake. In the lowest income households, unemployed status of household was additionally associated with decreased influenza vaccine uptake (adjusted odds ratio 0.50, p = 0.003).

Conclusions: This study identified income-based disparities in the responsive increase of influenza vaccination during the COVID-19 pandemic. Lower-income households exhibited a disproportionate reduction in influenza vaccine uptake, emphasizing the need for targeted support systems and expanded free vaccination for prioritized groups to address these disparities.

Keywords: COVID-19; Health Policy; Influenza vaccines; Socioeconomic disparities in Health; Vaccination hesitancy.

MeSH terms

  • Adult
  • Aged
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Female
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Influenza Vaccines* / administration & dosage
  • Influenza, Human* / epidemiology
  • Influenza, Human* / prevention & control
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Pandemics
  • Republic of Korea / epidemiology
  • Sociodemographic Factors
  • Socioeconomic Disparities in Health
  • Socioeconomic Factors*
  • Vaccination / statistics & numerical data
  • Vaccination Coverage / statistics & numerical data
  • Young Adult

Substances

  • Influenza Vaccines