Impact of the COVID-19 pandemic on influenza knowledge, attitudes, and vaccination practices in at-risk groups in the Kyrgyz Republic: A comparative study

Abstract

Instruction

Influenza remains a global health concern, causing significant annual morbidity and mortality. Vaccination is the most effective preventive measure; however, global vaccine coverage remains insufficient to establish herd immunity. In Kyrgyzstan, despite a national immunization program, influenza vaccine uptake among the risk groups has fluctuated between 11 % to 50 %. Understanding shifts in vaccination intentions before and during the COVID-19 pandemic is critical for refining public health strategies and institutional approach for improving vaccination coverage.

Methods

This cross-sectional study assessed influenza-related knowledge, attitudes, and practices (KAP) among risk groups (pregnant women, adults with chronic diseases, healthcare workers) in Kyrgyzstan before and during the pandemic (N = 7200). Data were analyzed using EPI Info, with descriptive statistics and logistic regression models to identify associations between socio-demographic/KAP factors and vaccination intentions/recommendations.

Results

Pre-pandemic, lower education (OR = 2.2; 95 %CI 1.4–3.2) and employment (OR = 1.4; 95 %CI 1.0–1.8) predicted higher vaccination intent among pregnant women; these associations waned during the pandemic, though women without comorbidities maintained stronger intent. Among adults with chronic diseases, divorced individuals (OR = 2.74; 95 %CI 1.12–6.6) in pre-pandemic and those distrusting vaccine protective effect (OR = 7.74; 95 %CI 4.2–14.1) showed heightened willingness for vaccination in the pandemic time. Healthcare workers with >5 years' experience and those treating children (OR = 2.39; 95 %CI 1.24–4.6) were more likely to recommend vaccines during the pandemic, reversing pre-pandemic trends. Prioritization of the target groups also shifted: older adults and comorbid patients gained emphasis during the pandemic, whereas children and medical staff were prioritized earlier.

Conclusion

The COVID-19 pandemic reshaped influenza vaccine uptake dynamics, altering socio-demographic predictors and KAP patterns. Addressing vaccine hesitancy, misinformation, and structural barriers through tailored education and proactive healthcare engagement is vital. These findings underscore the need for adaptable, context-sensitive vaccination strategies and robust public health interventions to sustain immunization progress in evolving epidemiological landscapes.