Behavioral and Sociodemographic Determinants of Influenza Vaccination Among Caregivers During the COVID-19 Pandemic

Abstract

Purpose

To assess whether caregiving status influenced influenza vaccination uptake during the COVID-19 pandemic and identify key sociodemographic, behavioral, and health-related determinants of vaccine receipt.

Design

Cross-sectional analysis using multivariable logistic regression models.

Setting

Twenty-six U.S. states that administered caregiver and marijuana modules in the Behavioral Risk Factor Surveillance System (BRFSS), 2021 and 2022.

Sample

105 384 adult BRFSS respondents; 21 965 identified as caregivers for individuals with health conditions or limitations.

Intervention

Not applicable.

Measures

Primary outcome was self-reported influenza vaccination in the past 12 months. Primary exposure was caregiver status. Covariates included age, sex, race/ethnicity, income, education, healthcare access, and health-related risk behaviors (eg, smoking, binge drinking).

Analysis

Weighted multivariable logistic regression assessed associations between caregiver status and vaccination. Interaction terms and caregiver-only models evaluated differential effects.

Results

Caregiver status was not significantly associated with influenza vaccination (AOR ≈ 1.0). Healthcare access (eg, recent check-up) strongly predicted vaccination (AOR ≈ 2.7), while risk behaviors reduced likelihood (AOR ≈ 0.7). Findings were consistent in analyses restricted to caregivers. Disparities were observed by race and sex.

Conclusion

Caregiver status alone did not predict influenza vaccination. Sociodemographic and behavioral factors, particularly healthcare access and risk behaviors were stronger influences. Interventions addressing structural barriers and behavioral risks may improve caregiver vaccination rates.