ArticlePloS one2025
Vaccine fatigue and influenza vaccination trends across Pre-, Peri-, and Post-COVID-19 periods in the United States using epic's cosmos database.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed.
- Review
- Game Over for the Baseline: Influenza Hospitalization Patterns Before, During, and After the COVID-19 Pandemic (FluSurv-NET, 2009-2025).Infectious disease reports · 2026Article
- Determinants of influenza vaccination uptake in older adults: findings from a retrospective cross-sectional study.BMC public health · 2026Article
- Building on Vaccine Confidence in the Aftermath of the Pandemic: A Qualitative Study in Primary Care Physicians.Vaccines · 2026Article
- Parental Attitudes and Hesitancy Towards Childhood Influenza Vaccination in Slovakia: A Cross-Sectional Survey of 301 Parents.Children (Basel, Switzerland) · 2026Article
- Review
- Determinants of Influenza Vaccine Uptake Among Rural Populations in a Southeastern U.S. State.Vaccines · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionInfluenza vaccination is a critical public health measure, especially amidst the challenges of the COVID-19 pandemic. This study uses Epic's Cosmos database to analyze influenza vaccination trends across demographic groups in the United States, examining the effects of the COVID-19 pandemic and "vaccine fatigue" on influenza vaccination rates.
methodsThis retrospective cross-sectional study analyzes influenza vaccination rates pre- (1 May 2018-31 May 2019), peri- (1 May 2020-31 May 2021), and post-COVID-19 (1 May 2023-31 May 2024). A two-proportion z-test and Cohen's h test were calculated to assess statistical significance.
resultsInfluenza vaccination rates increased peri-COVID (+1.99% point change, h = 0.04, p < 0.001) and decreased post-COVID (-6.41% point change, h = 0.14, p < 0.001) relative to pre-COVID. The largest changes were observed in the following groups: 5-18 year olds (-13.92% point change, h = 0.31, p < 0.001), 19-26 year olds (-9.91% point change, h = 0.25, p < 0.001), American Indian or Alaska Native (-8.11% point change, h = 0.18, p < 0.001), Other Races (-7.36% point change, h = 0.17, p < 0.001), White (-6.89% point change, h = 0.15, p < 0.001), and the South U.S. census region (-7.21% point change, h = 0.17, p < 0.001).
conclusionPost-pandemic influenza vaccination compliance decreased relative to pre-pandemic, especially among younger age groups, certain racial groups, and in the southern U.S. These findings suggest that the COVID-19 pandemic negatively impacted influenza vaccination compliance. While overall trends aligned with publicly available data, absolute counts may be under-reported within Epic due to incomplete documentation of vaccine administrations outside of Epic-affiliated systems.
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