Determinants of influenza vaccination in a French primary care population in the post-COVID-19 era.

Publication date: Jul 20, 2026

Influenza vaccination coverage in France remains suboptimal, with variability across population groups. We assessed demographic and behavioral determinants of influenza vaccination in the post-COVID-19 period among a primary care population in the Haute-Vienne department (Nouvelle-Aquitaine, France). We conducted a cross-sectional survey using an anonymous, self-administered questionnaire distributed to adults attending five general-practice sites between May and July 2023. The primary outcome was receipt of the 2022-2023 influenza vaccine. Candidate determinants included age, sex, municipality size, socio-professional category, eligibility criteria (age ≥ 65 years, healthcare-worker status, chronic conditions, or pregnancy), prior influenza vaccination, number of COVID-19 vaccine doses received, and self-reported history of influenza infection. Associations were examined using chi-square tests, Cochran-Armitage trend tests, and univariate logistic regression. Two multivariable logistic regression models were then constructed: a demographic model including age, sex, municipality size, socio-professional category, and the presence of any comorbidity or pregnancy, and a behavioral model including prior influenza vaccination and COVID-19 vaccination status (≥ 3 doses vs.  ≤ 2 doses). Adjusted results were expressed as adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). Among the 800 questionnaires distributed, 432 were returned (participation rate: 54%). Overall, 75. 9% of participants met at least one eligibility criterion for influenza vaccination. Influenza vaccination coverage for the 2022-2023 season was 58. 3% and differed by municipality size (38. 8% in areas with fewer than 5,000 inhabitants; 59. 2% in those with 5,000-10,000; and 64. 3% in those with more than 10,000, p = 0. 0003) and increased with the regularity of prior influenza vaccination (6. 7% among never vaccinated, 55. 9% among occasional, and 96. 6% among annually vaccinated, p 

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