Job Insecurity and Symptoms of Anxiety and Depression Among U.S. Young Adults During COVID-19

PurposeThis study aimed to estimate the associations between job insecurity and symptoms of anxiety and depression among U.S. young adults amidst the COVID-19 pandemic.MethodsWe analyzed data on young adults aged 18–26 years from June 15 to June 30, 2020, from the weekly, cross-sectional Household Pulse Survey (n = 4,852) conducted by the U.S. Census Bureau. Two job insecurity measures and four anxiety and depression measures were analyzed using multivariable Poisson regression models adjusting for age, sex, race/ethnicity, education, and marital status.ResultsFifty-nine percent of participants experienced direct or household employment loss since the start of the COVID-19 pandemic, and 38% were expected to experience direct or household employment loss in the coming 4 weeks. Recent direct or household employment loss and expected direct or household employment loss, among participants who did not experience recent employment loss, were associated with a greater risk of poor mental health on all four measures.ConclusionsU.S. young adults experience a significant mental health burden as a result of job insecurity amidst the COVID-19 pandemic.     

Shelter in Place,Connect Online: Trending TikTok Content During the Early Days of the U.S. COVID-19 Pandemic

PurposeIn the U.S., TikTok surged in popularity as the COVID-19 virus spread nationally. TikTok posts may both reflect and shape young people's perceptions of the pandemic. This mixed methods study applied a uses and gratifications framework to a systematic analysis of trending TikToks related to COVID-19, with attention to changes over a 2-month period.MethodsAnalyses are based on an original data set of 2,675 TikToks (529 unique videos across 68 COVID-relevant hashtags) viewed over 2,840,347,014 times. TikToks were tracked daily for 65 days after the beginning of U.S. stay-at-home orders (March 17 to May 20, 2020). A thematic analysis used 28 content codes and nine codes related to subject(s) to examine content patterns. Chi-square tests facilitated analyses of changes over time.ResultsTrending TikToks related to COVID-19 most often featured details of everyday circumstances and/or relatable commentary on Pandemic Life. These posts were similarly prevalent in Months 1 and 2. Health-Promoting TikToks outnumbered those exhibiting Risky or Concerning Health Practices (58:13) and were more common in Month 1. Advertisements and sponsored campaigns also shaped trending COVID-relevant content during the study period.ConclusionsOn TikTok, public health information appears to coexist with an abundance of commentary about everyday life during the pandemic. Posts arguably reflect documented social media use goals such as information seeking/sharing, archiving, and self-expression. Yet, TikToks during the pandemic period perhaps most often connect to another previously undocumented use goal: a digital search for common humanity in seeing difficult experiences as part of a larger human experience.     

National Study of Youth Opinions on Vaccination for COVID-19 in the U.S.

PurposeThis study aimed to understand the potential barriers and facilitators to COVID-19 vaccination among youth.MethodsOpen-ended questions regarding COVID-19 vaccination were posed to a national cohort of 14- to 24-year-olds (October 30, 2020). Responses were coded through qualitative thematic analysis. Multivariable logistic regression tested the association of demographic characteristics with vaccination unwillingness.ResultsAmong 911 respondents (response rate = 79.4%), 75.9% reported willingness to receive a COVID-19 vaccine, 42.7% had unconditional willingness, and 33.3% were conditionally willing, of which the majority (80.7%) were willing if experts deemed vaccination safe and recommended. Preferred vaccine information sources were medical organizations (42.3%; CDC, WHO) and health care professionals (31.7%). Frequent concerns with vaccination included side effects (36.2%) and efficacy (20.1%). Race predicted vaccination unwillingness (Black: odds ratio = 3.31; and Asian: odds ratio = .46, compared with white, p < .001).ConclusionMost youth in our national sample were willing to receive a COVID-19 vaccine when they believe it is safe and recommended. Public health experts and organizations must generate youth-centered materials that directly address their vaccination concerns.     

Older adolescents and young adults willingness to receive the COVID-19 vaccine: Implications for informing public health strategies

ImportanceThe success in ending the COVID-19 pandemic rests partly on the mass uptake of the COVID-19 vaccine. Little work has been done to understand vaccine willingness among older adolescents and young adults. This is important since this age group may be less likely to adhere to public health guidelines.ObjectiveTo understand willingness of getting a vaccine and reasons for vaccine hesitancy among a sample of older adolescents and young adults.DesignData were from the Well-Being and Experiences study (The WE Study), a longitudinal community-based sample of older adolescents and young adults collected from Winnipeg, Manitoba, Canada from 2017 to 2020 (n = 664).SettingThe study setting was a community-based observational longitudinal study.ParticipantsParticipants for the study were aged 14 to 17 years old at baseline in 2016–17 (n = 1000). Data were also collected on one parent/caregiver. Waves 2 (n = 747) and 3 (n = 664) were collected in 2019 and 2020, respectively.ExposuresThe main exposures were sociodemographic factors, health conditions, COVID-19 knowledge, and adversity history.Main OutcomesThe main outcomes were COVID-19 vaccine willingness, hesitancy, and reasons for hesitancy.ResultsWillingness to get a COVID-19 vaccine was 65.4%. Willingness did not differ by age, sex, or mental health conditions, but did differ for other sociodemographic characteristics, physical health conditions, COVID-19 knowledge, practicing social/physical distancing, and adversity history. The most common reasons for not wanting a vaccine were related to safety, knowledge, and effectiveness. Sex differences were noted.Conclusions and RelevanceIncreasing uptake of the COVID-19 vaccine among older adolescents and young adults may rely on targeting individuals from households with lower income, financial burden, and adversity history, and generating public health messaging specifically aimed at vaccine safety, how it works to protect against illness, and why it is important to protect oneself against a COVID-19 infection.     

U.S. public support for COVID-19 vaccine donation to low- and middle-income countries during the COVID-19 pandemic

As COVID-19 vaccines become available to the public, there will be a massive worldwide distribution effort. Vaccine distribution has historically been unequal primarily due to the inability of nations with developing economies to purchase enough vaccine to fully vaccinate their populations. Inequitable access to COVID-19 vaccines will not just cause humanitarian suffering, it will likely also be associated with increased economic suffering worldwide. This study focuses on the U.S. population and its beliefs about future COVID-19 vaccine donation by the U.S. to low- and middle-income countries.This study carried out a survey among 788 U.S. adults. Variables include demographics, COVID-19 vaccine priority status, COVID-19 vaccine donation beliefs, and Social Dominance Orientation.Analyses showed that older respondents were both less likely to endorse higher levels of COVID-19 vaccine donations and were more likely to want to wait until all in the U.S. who want the vaccine have received it; those who identified as Democrats were more likely to endorse higher levels of future COVID-19 vaccine donation than Republicans; and those scoring higher on SDO were both less likely to endorse higher levels of COVID-19 vaccine donations as well as more likely to want to wait until all in the U.S. who want the vaccine have received it. Policymakers, as well as healthcare providers and public health communication professionals, should give consideration to those messages most likely to engender support for global prevention efforts with each audience segment.     

The Impact of Positive Youth Development Attributes on Posttraumatic Stress Disorder Symptoms Among Chinese Adolescents Under COVID-19

PurposeThis study examined the prevalence of posttraumatic stress disorder (PTSD) symptoms among adolescents in mainland China under COVID-19. The direct effects of the perceived threat of COVID-19 and positive youth development (PYD) qualities, as well as the moderating effect of PYD qualities on PTSD symptoms, were studied.MethodsFive schools in Chengdu, Sichuan, China, participated in this study. Two waves of data were collected before school lockdown (Wave 1, between December 2019 and January 2020) and after school resumption (Wave 2, between June 2020 and July 2020), respectively. A total of 4,981 adolescents aged above 11 years (Mean age = 13.15, SD = 1.32 at Wave 1, 51.5% girls) completed questionnaires at both waves. Students responded to measures of PYD qualities at both waves and perceived threat and PTSD symptoms at Wave 2.ResultsA total of 517 adolescents (10.4%) could be regarded as having PTSD. Results indicated significant unique main effects of perceived threat (β = .13, p < .001) and Wave 1 PYD qualities (β = ?.16, p < .001) on PTSD symptoms. Besides, results showed a significant moderating effect of PYD qualities in mitigating the negative impact of perceived threat on PTSD symptoms.ConclusionsThis study revealed the protective effect of PYD attributes in reducing the negative influence of traumatic situations such as COVID-19 on adolescent mental health. Results underscore the importance of promoting PYD qualities in adolescents in mainland China via effective PYD programs.     

Individual-level factors associated with COVID-19 vaccine acceptance among U.S. patients with cancer

IntroductionVaccine hesitancy in the wake of the COVID-19 pandemic is a major public health concern in the US. Cancer patients are especially vulnerable to adverse COVID-19 outcomes and require targeted prevention efforts against COVID-19.MethodsWe used longitudinal survey data from patients seen at Moffitt Cancer Center to identify attitudes, beliefs, and sociodemographic factors associated with COVID-19 vaccination acceptance among cancer patients. Patients with confirmed invasive cancer diagnosis through Cancer Registry data were asked about vaccine acceptance through the question “Now that a COVID-19 vaccine is available, are you likely to get it?” and dichotomized into high accepters (already received it, would get it when available) and low accepters (waiting for a doctor to recommend it, waiting until more people received it, not likely to get it).ResultsMost patients (86.8% of 5,814) were high accepters of the COVID-19 vaccine. High accepters had more confidence in the effectiveness and safety of the vaccine than low accepters. Multivariable logistic regression showed older individuals (70–89 vs.18–49: OR:2.57, 95% CI:1.33–4.86), those with greater perceived severity of COVID-19 infection (very serious vs. not at all serious: OR:2.55, 95% CI:1.76–3.70), practicing more risk mitigation behaviors (per one standard deviation OR:1.75, 95% CI:1.57–1.95), and history of receiving the flu shot versus not (OR:6.56, 95% CI:5.25–8.20) had higher odds of vaccine acceptance. Individuals living with more than one other person (vs. alone: OR: 0.53, 95% CI: 0.35, 0.79) and those who were more socioeconomically disadvantaged (per 10 percentile points: OR: 0.89, 95 %CI: 0.85, 0.93) had lower odds of reporting vaccine acceptance.ConclusionMost patients with cancer have or would receive the COVID-19 vaccine. Those who are less likely to accept the vaccine have more concerns regarding effectiveness and side effects, are younger, more socioeconomically disadvantaged, and have lower perceptions of COVID-19 severity.     

COVID-19 vaccine intention among young adults: Comparative results from a cross-sectional study in Canada and France

BackgroundHigh rates of COVID-19 vaccination uptake are required to attain community immunity. This study aims to identify factors associated with COVID-19 vaccine uncertainty and refusal among young adults, an underexplored population with regards to vaccine intention generally, in two high-income settings: Canada and France.MethodsA cross-sectional online survey was conducted from October to December 2020 among young adults ages 18–29 years (n = 6663) living in Canada (51.9%) and France (48.1%). Multinomial logistic regression analyses were performed to identify the sociodemographic and COVID-19-related measures (e.g., prevention behavior and perspectives, health-related concerns) associated with vaccine uncertainty and refusal. ?We conducted weighted analyses by age, gender and province/region of residence.ResultsIntention to accept vaccination was reported by 84.3% and 59.7% of the sample in Canada and France, respectively. Higher levels of vaccine uncertainty and refusal were observed in France compared to Canada (30.1% versus 11%, 10.2% versus 4.7%). In both countries, we found higher levels of vaccine acceptance among young adults who reported COVID-19 prevention actions. Vaccine uncertainty and refusal were associated with living in a rural area, having lower levels of educational attainment, not looking for information about COVID-19, not wearing a face mask, and reporting a lower level of concern for COVID-19′s impact on family. Participants who had been tested for COVID-19 were less likely to intend to refuse a vaccine.ConclusionsCOVID-19 vaccine acceptance was high among young adults in Canada and France during a time in which vaccines were approved for use. Targeted interventions to build confidence in demographic groups with greater hesitance (e.g., rural and with less personal experience with COVID-19) may further boost acceptance and improve equity as vaccine efforts continue to unfold.     

Sociodemographic and psychological correlates of COVID-19 vaccine hesitancy and resistance in the young adult population in Italy

BackgroundPrevious research has shown that young adults are more hesitant/resistant to COVID-19 vaccine uptake than older age groups, although the factors underlying this tendency are still under debate. The current study aimed to identify the sociodemographic and psychological correlates of vaccine hesitancy and resistance among young adults (18–40 years) during the nationwide COVID-19 vaccination campaign in Italy, the first country after China being hit by the pandemic and which suffered a large number of fatalities.MethodsThis is a cross-sectional, web-based study conducted in Italy using an ISO-certified international survey company (respondi.com). Data were collected on 1200 participants in June 2021.ResultsVaccine hesitancy/resistance was found for 25% of the sample. In multinomial logistic regression (N = 1159), being aged 30–40 years, residing in northern Italy, having lower educational and income level, being unemployed, and not knowing any friends/relatives diagnosed with COVID-19 were associated with higher odds of hesitancy or resistance. In multivariate analysis of variance (N = 1177), both vaccine hesitant and resistant young adults perceived significantly less social support from friends and family than vaccine accepting ones. Resistant individuals reported significantly higher levels of conspiracy theories and negative attitudes toward vaccines than their accepting and hesitant counterparts. Moreover, resistant individuals reported significantly lower levels of attachment to country and perceptions of a just government compared to accepting ones, with hesitant young adults scoring in between.ConclusionsOur findings support the idea that young adults with a hesitant (vs. resistant) attitude show a more nuanced and less extreme psychological profile. Public health messaging should capitalize on social media to provide accessible, transparent, and age-appropriate information concerning COVID-19 vaccine safety. Moreover, policy efforts improving the availability of social support systems are warranted to strengthen connectedness and foster trust in institutions amongst this particular segment of the population.     

COVID-19 vaccination intention and behavior in a large,diverse, U.S. refugee population

IntroductionRefugees often face increased risk of exposure to COVID-19 due to their disproportionate representation in the essential workforce and crowded household conditions. There is a paucity of data about risk factors for under-immunization for COVID-19 among refugees.MethodsRefugees were surveyed in two phases that corresponded to before and after wide availability of COVID-19 vaccines. Participants were asked about their attitudes, and perceptions about COVID-19, previous acceptance of vaccines, sources utilized to obtain trusted health information, and intent to get vaccinated. The overall participant vulnerability was assessed using the social vulnerability index. In-depth semi-structured interviews were completed with key stakeholders through snowball sampling.ResultsOf 247 refugees, 244 agreed to participate in the initial survey. Among those, 140 (57.4%) intended to get vaccinated, 43 (17.6%) were unsure, and 61 (25%) did not intend to get vaccinated. In the follow up survey, all 215 who were reached, agreed to provide information about their vaccination status. Among those respondents, 141 (65.6%) were either vaccinated or expressed intent to do so, and 74 (34.4%) remained hesitant. We did not observe any significant correlation between socio-demographic variables, country of origin, and vaccination status/intent. Among those who initially intended to get vaccinated, nearly 1 in 5 changed their mind and decided to forego vaccination, and among those who initially did not plan getting vaccinated, 1 in 3 changed their mind and got vaccinated. Fears related to the vaccine, concerns that the vaccine is religiously prohibited, “wait and see” how others did with the vaccine, communication and transportation barriers were commonly cited as reason not to get vaccinated.ConclusionsOver a third of refugees in our study were hesitant to get vaccinated. Refugees desired additional education about the benefits and safety of vaccines along with easier access to vaccination clinics in their communities.     

Joining the herd? U.S. public opinion and vaccination requirements across educational settings during the COVID-19 pandemic

With effective and safe COVID-19 vaccines beginning to be distributed across the United States, questions about who should receive the vaccine first have been the focus of public discussions. Yet, over the long-term, questions about the order of distribution will be displaced by questions about how to achieve high levels of vaccination rates. Historically, absent incentives or mandates, Americans have shown ambivalence, if not general antipathy, towards vaccinations, and vaccination rates have generally been low for many vaccines. There is evidence that vaccination requirements across educational settings are an effective policy instrument to increase vaccination rates. We administered a large national survey to assess American’s attitudes towards vaccination requirements across three educational settings (daycare, K-12 schools, and universities) in general and for COVID-19 specifically. Partisanship, gender, race, rurality, and perceptions about the appropriate role schools should play in providing health services are substantive predictors of public opinion. While Americans generally support vaccination mandates across all three settings for both types of requirements, support is consistently and significantly lower for COVID19 requirements. The effect of partisanship is accentuated for COVID-19 requirements as compared to general requirements. Drop off in support between general and COVID-19 specific requirements are driven by partisanship, gender, political knowledge, rurality, and having children in the household. Nonetheless, mandates are supported by a majority of Americans. Assessing Americans’ opinions of vaccination requirements in educational settings offers an important opportunity to explore the potential of mandates as policy instrument in the government’s arsenal against COVID-19 and guide public policy on the issues.     

U.S. Nursing Home Quality Ratings Associated with COVID-19 Cases and Deaths

ObjectivesTo inform future policies and disaster preparedness plans in the vulnerable nursing home setting, we need greater insight into the relationship between nursing homes’ (NHs’) quality and the spread and severity of COVID-19 in NH facilities. We therefore extend current evidence on the relationships between NH quality and resident COVID-19 infection rates and deaths, taking into account NH structural characteristics and community characteristics.DesignCross-sectional study.Setting and Participants15,390 Medicaid- and Medicare-certified NHs.MethodsWe obtained and merged the following data sets: (1) COVID-19 weekly data reported by each nursing home to the Centers for Disease Control and Prevention’s National Healthcare Safety Network, (2) Centers for Medicare & Medicaid Services Five Star Quality Rating System, (3) county-level COVID-19 case counts, (4) county-level population data, and (5) county-level sociodemographic data.ResultsAmong 1-star NHs, there were an average of 13.19 cases and 2.42 deaths per 1000 residents per week between May 25 and December 20, 2020. Among 5-star NHs, there were an average of 9.99 cases and 1.83 deaths per 1000 residents per week. The rate of confirmed cases of COVID-19 was 31% higher among 1-star NHs compared with 5-star NHs [model 1: incidence rate ratio (IRR) 1.31, 95% confidence interval (CI) 1.23-1.39], and the rate of COVID-19 deaths was 30% higher (IRR 1.30, 95% CI 1.20, 1.41). These associations were only partially explained by differences in community spread of COVID-19, case mix, and the for-profit status and size of NHs.Conclusions and ImplicationsWe found that COVID-19 case and death rates were substantially higher among NHs with lower star ratings, suggesting that NHs with quality much below average are more susceptible to the spread of COVID-19. This relationship, particularly with regard to case rates, can be partially attributed to external factors: lower-rated NHs are often located in areas with greater COVID-19 community spread and serve more socioeconomically vulnerable residents than higher-rated NHs.     

Evaluation of potential adverse events following COVID-19 mRNA vaccination among adults aged 65 years and older: Two self-controlled studies in the U.S.

BackgroundOur near-real-time safety monitoring of 16 adverse events (AEs) following COVID-19 mRNA vaccination identified potential elevation in risk for six AEs following primary series and monovalent booster dose administration. The crude association with AEs does not imply causality. Accordingly, we conducted robust evaluation of potential associations.MethodsWe conducted two self-controlled case series studies of COVID-19 mRNA vaccines (BNT162b2 and mRNA-1273) in U.S. Medicare beneficiaries aged ≥ 65 years. Adjusted incidence rate ratio (IRRs) and 95 % confidence intervals (CIs) were estimated following primary series doses for acute myocardial infarction (AMI), pulmonary embolism (PE), immune thrombocytopenia (ITP), disseminated intravascular coagulation (DIC); and following monovalent booster doses for AMI, PE, ITP, Bell’s Palsy (BP) and Myocarditis/Pericarditis (Myo/Peri).ResultsThe primary series study included 3,360,981 individuals who received 6,388,542 primary series doses; the booster study included 6,156,100 individuals with one monovalent booster dose. The AMI IRR following BNT162b2 primary series and booster was 1.04 (95 % CI: 0.91 to 1.18) and 1.06 (95 % CI: 1.003 to 1.12), respectively; for mRNA-1273 primary series and booster, 1.01 (95 % CI: 0.82 to 1.26) and 1.05 (95 % CI: 0.998 to 1.11), respectively. The hospital inpatient PE IRR following BNT162b2 primary series and booster was 1.19 (95 % CI: 1.03 to 1.38) and 0.86 (95 % CI: 0.78 to 0.95), respectively; for mRNA-1273 primary series and booster, 1.15 (95 % CI: 0.94 to 1.41) and 0.87 (95 % CI: 0.79 to 0.96), respectively. The studies’ results do not support that exposure to COVID-19 mRNA vaccines elevate the risk of ITP, DIC, Myo/Peri, and BP.ConclusionWe did not find an increased risk for AMI, ITP, DIC, BP, and Myo/Peri and there was not consistent evidence for PE after exposure to COVID-19 mRNA primary series or monovalent booster vaccines. These results support the favorable safety profile of COVID-19 mRNA vaccines administered in the U.S. elderly population.     

Reimagining Infection Control in U.S. Nursing Homes in the Era of COVID-19

Residents of nursing homes (NHs) are susceptible to infection, and these facilities, particularly those that provide post-acute care services, are high-risk settings for the rapid spread of communicable respiratory and gastrointestinal illnesses, as well as antibiotic-resistant bacteria. The complexity of medical care delivered in most NHs has increased dramatically over the past 2 decades; however, the structure and resources supporting the practice of infection prevention and control in these facilities has failed to keep pace. Rising numbers of infections caused by Clostridioides difficile and multidrug-resistant organisms, as well as the catastrophic effects of COVID-19 have pushed NH infection control resources to a breaking point. Recent changes to federal regulations require NHs to devote greater resources to the facility infection control program. However, additional changes are needed if sustained improvements in the prevention and control of infections and antibiotic resistance in NHs are to be achieved.     

Adapting the Motors of Influenza Vaccination Acceptance Scale into the Motors of COVID-19 Vaccination Acceptance Scale: Psychometric evaluation among mainland Chinese university students

BackgroundCOVID-19 continues to ravage the world with economies and life significantly and negatively affected. Fortunately, there has been significant progress in the production of vaccines to stem the infection. However, with controversies and myths surrounding vaccinations, it is timely to examine individuals’ willingness to vaccinate. The present study adapted the Motors of Influenza Vaccination Acceptance Scale (MoVac-Flu Scale) into the Motors of COVID-19 Vaccination Acceptance Scale (MoVac-COVID19S) for validation and assessed the acceptance of COVID-19 vaccination utilizing the cognitive model of empowerment (CME).MethodsA total of 3145 university students (mean age = 20.80 years; SD = 2.09) were recruited for the present study between January 5 and 16, 2021. Two MoVac-COVID19S scales (9-item and 12-item) were adapted from the MoVac-Flu Scale, an instrument developed using CME. Psychometric tests were conducted to ascertain reliability and validity properties.ResultsThe findings indicated that the MoVac-COVID19S had high internal consistency in both the 9-item version (ω = 0.921) and 12-item version (ω = 0.898). The factor structure of the MoVac-COVID19S (9-item and 12-item versions) corresponded well with CME theory. All the fit indices were satisfactory (comparative fit index = 0.984, Tucker-Lewis index = 0.971, root mean square error of approximation = 0.088, standardized root mean square residual = 0.058) but the 9-item MoVac-COVID had better fit indices than the 12-item MoVac-COVID due to the negative wording effects existing in the 12-item MoVac-COVID19S. The scale had satisfactory known-group validity in both 9-item and 12-item versions.ConclusionsThe MoVac-COVID19S has promising psychometric properties based on internal consistency, factor structure, and known-group validity.     

Older adults: panoramic view on the COVID-19 vaccination

In December 2020, COVID-19 vaccination started in many countries, with which the world community hopes to stop the further spread of the current pandemic. More than 90% of sick and deceased patients belong to the category of older adults (65 years and older). This category of the population is most vulnerable to infectious diseases, so vaccination is the most effective preventive strategy, the need for which for older adults is indisputable. Here we briefly summarize information about age-related changes in the immune system and present current data on their impact on the formation of the immune response to vaccination. Older age is accompanied by the process of biological aging accompanied by involution of the immune system with increased susceptibility to infections and a decrease in the effect of immunization. Therefore, in the ongoing mass COVID-19 vaccination, the older adults are a growing public health concern. The authors provide an overview of the various types of COVID-19 vaccines approved for mass immunization of the population by the end of 2020, including older adults, as well as an overview of strategies and platforms to improve the effectiveness of vaccination of this population. In the final part, the authors propose for discussion a system for assessing the safety and monitoring the effectiveness of COVID-19 vaccines for the older adults.     

Influenza vaccination in the time of COVID-19: A national U.S. survey of adults

IntroductionDecisions about influenza vaccination for fall-winter 2020 were made against the backdrop of the COVID-19 pandemic. During May 2020, the authors examined intended vaccination in the next 12 months in relationship to demographic variables, healthcare attitudes, and personal COVID-19 experiences for two samples of adults--those who did not receive influenza vaccine during the prior 12 months, and those who did.MethodsIn May 2020, a cross-sectional online survey was conducted with a national US sample. Participants reported prior influenza vaccination (yes/no during prior 12 months) and anticipated vaccination (yes/no during next 12 months). Covariates included demographic characteristics (e.g., gender, race-ethnicity, political ideology), general beliefs (e.g., benefits of vaccines, altruistic attitudes), and COVID-19 health beliefs and experiences (COVID-19 worry and severity, perception of COVID-19 as a community threat, knowing someone with COVID-19). For each group, hierarchical multivariable logistic regression was conducted with intent to vaccinate as the outcome.ResultsAmong participants (n = 3502), 47% did not receive influenza vaccine in the prior 12 months and 53% had; 25.5% of non-vaccinators and 91.9% of vaccinators intended future vaccination. For non-vaccinators, odds of intending vaccination was associated with race/ethnicity (Hispanics were more likely to intend than white-NH; AOR = 1.74; 95% CI = 1.23–2.4), greater perceived benefits of vaccination (AOR = 2.19; 95% CI = 1.88–2.54), and perception of COVID-19 as a community threat (AOR = 1.91; 95% CI = 1.49–2.45). For vaccinators, odds of intending vaccination was associated with age (AOR = 1.04; 95% CI = 1.03–1.05), race/ethnicity (Black-NH and Other-NH were less likely to intend than white-NH, AOR = 0.60; 95% CI = 0.36–0.999; and AOR = 0.45; 95% CI = 0.24–0.84, respectively), greater perceived benefits of vaccination (AOR = 1.88; 95% CI = 1.45–2.45) and greater perception of collective benefits of vaccines (AOR = 1.48; 95% CI = 1.15–1.90).ConclusionsThe COVID-19 pandemic may have served as a cue to action for influenza vaccination intention among some prior non-vaccinators whereas intention among prior vaccinators is more related to positive attitudes toward vaccination.