Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Kathleen Winter

Committee Member

Dr. Marc Kiviniemi

Committee Member

Dr. Ketrell McWhorter


Fall 2023 COVID-19, Influenza, and Respiratory Syncytial Virus Vaccine Uptake in Kentucky

Background: In the fall of 2023, vaccine recommendations included updated COVID-19 and influenza vaccines, as well as a new vaccine and immunization for respiratory syncytial virus (RSV). Vaccine co-administration, the administration of more than one vaccine in one vaccination session, is safe and effective for COVID-19, influenza, and RSV vaccines and can improve vaccine uptake for all recommended vaccines (Bonanni, et al., 2023; CDC, 2023). The COVID-19 pandemic altered the landscape for locations where people receive vaccinations, and it may be beneficial to public health to have more information on where people are receiving their vaccinations in 2023.

Methods: This cross-sectional study utilized immunization data for Kentucky residents as reported into the Kentucky Immunization Registry (KYIR) from September 1, 2023, to November 30, 2023, for COVID-19, influenza, and RSV vaccinations including the RSV antibody immunization for infants. We studied each of the three vaccines for vaccine uptake and also COVID-19 and influenza co-administration. Analyses included the following indicator variables: age, gender, race, ethnicity, and vaccination location.

Results: Out of 1,273,847 vaccinations analyzed, 298,349 were for COVID-19, 893,811 were for influenza, and 81,687 were for RSV. Out of 859,295 who received either a COVID-19 or influenza vaccine, 138,685 (15.5%) were co-administered. Vaccine uptake for all three vaccines saw peak numbers around early to mid-October. For each of the three vaccines, more females than males were reported receiving them (COVID-19: 55%; influenza: 57%; RSV: 58%) but the odds of co-administration for COVID-19 and influenza vaccines were higher in males (OR (95% CI)*: 1.203 (1.189-1.217)). The majority of all analyzed vaccinations were received by adults aged 60 and older (COVID-19: 67%; influenza: 48%; RSV: 96%), and the odds of co-administration for COVID-19 and influenza were 1.789 times higher for those age 60-74 compared to those aged 18-39.

Conclusion: Influenza vaccine uptake was different from COVID-19 and RSV outcomes in race and age category proportions, and the majority of influenza vaccinations were received in healthcare clinic/hospital settings as opposed to pharmacy settings. Vaccinations were more common in females, but the odds of co-administration for COVID-19 and influenza were higher for males. This data demonstrates a need for further studies on vaccine uptake and co-administration to determine trends and areas for improvement in increasing the co-administration of vaccines.

Available for download on Wednesday, October 30, 2024

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