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<p>Achieving high vaccination coverage is a critical challenge during both crisis and routine outbreaks of infectious diseases. Previous studies have largely focused on single vaccination behaviors and vaccine-specific attitudes. A three-wave prospective longitudinal study was conducted to investigate the complex relationships between influenza vaccination behavior, COVID-19 vaccination behavior, and general vaccine hesitancy across different peri-pandemic phases. Uptake of pre-pandemic influenza vaccination was associated with uptake of full COVID-19 vaccination during the outbreak of COVID-19, which was further associated with uptake of influenza vaccination in the post-emergency phase when a strong resurgence of seasonal influenza occurred. The specific vaccination behaviors and negative general attitudes toward vaccination had reciprocal relationships across the peri-pandemic phases. Reduced negative attitudes toward vaccination mediated the spillover between influenza and COVID-19 vaccination behaviors. This suggests that general vaccine hesitancy could have a profound impact on shaping specific vaccination behaviors across target diseases and risk communication contexts. Two-tier promotion strategies can help effectively promote vaccinations and better prepare for future pandemics.</p>

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Spillover between influenza and COVID-19 vaccination behaviors across pandemic phases and implications for general vaccine hesitancy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月16日

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  • Sitong Luo,
  • Siwen Huang,
  • Edmund W. J. Lee,
  • Hui Jiang,
  • Luyao Xie,
  • Xinchen Ye,
  • Ho Hin Lee,
  • Kam Hei Hui,
  • Phoenix K. H. Mo,
  • Meiqi Xin

摘要

Achieving high vaccination coverage is a critical challenge during both crisis and routine outbreaks of infectious diseases. Previous studies have largely focused on single vaccination behaviors and vaccine-specific attitudes. A three-wave prospective longitudinal study was conducted to investigate the complex relationships between influenza vaccination behavior, COVID-19 vaccination behavior, and general vaccine hesitancy across different peri-pandemic phases. Uptake of pre-pandemic influenza vaccination was associated with uptake of full COVID-19 vaccination during the outbreak of COVID-19, which was further associated with uptake of influenza vaccination in the post-emergency phase when a strong resurgence of seasonal influenza occurred. The specific vaccination behaviors and negative general attitudes toward vaccination had reciprocal relationships across the peri-pandemic phases. Reduced negative attitudes toward vaccination mediated the spillover between influenza and COVID-19 vaccination behaviors. This suggests that general vaccine hesitancy could have a profound impact on shaping specific vaccination behaviors across target diseases and risk communication contexts. Two-tier promotion strategies can help effectively promote vaccinations and better prepare for future pandemics.