The effect of vaccine mandate announcements on vaccine uptake in Canada: An interrupted time series analysis

Understanding the shift in COVID-19 vaccine hesitancy and its associated factors for primary and booster doses among university students: A cross-sectional study

BACKGROUND

Vaccine hesitancy (VH) poses a major challenge to achieving high COVID-19 vaccination rates. Universities, with mandatory primary dose policies but optional boosters, offer a unique setting to study VH dynamics. This study aimed to estimate COVID-19 VH prevalence and identify key factors influencing VH across primary and booster doses among university students.

METHODS

In this cross-sectional study, all actively enrolled students at the University of Waterloo, Ontario, Canada, during Winter 2024 were invited to complete an online survey. Means and standard deviations were calculated for VH scores and proportions were calculated for the binary VH. Differences were compared using paired t-tests and chi-square. Generalized Estimating Equations was applied to model changes in VH scores from primary to boosters and identify key predictors of VH. Interaction terms were tested to evaluate dose-specific effects on VH.

RESULTS

Among 4453 respondents, VH prevalence increased from 17 % for primary doses to 33.4 % for boosters, with higher VH scores for boosters (Mean ± SD: 10.9 ± 8.1) than primary doses (Mean ± SD: 7.3 ± 7.1). Women (aOR = 1.06, 95 % CI 1.01-1.11) and younger students (aOR = 1.62, 95 % CI 1.25-2.10) showed the largest VH increases, especially for boosters. Students with low perceived risk, negative perceptions of boosters' safety and effectiveness, low intention to follow government recommendations, and no prior flu or meningococcal vaccination exhibited the greatest VH increases when shifting from primary to booster doses. Conversely, students with no religious affiliation and those whose decisions were unaffected by mandates showed smaller changes in VH.

CONCLUSION

The rise in VH from primary to booster doses appears driven by demographic, psychological, and behavioral factors. Tailored interventions that promote clear communication, improve access, and strengthen confidence in booster recommendations rather than reliance on mandates are critical for reducing VH and sustaining vaccine uptake in this population.

Did inequalities in COVID-19 vaccination resolve over time? Insights from the Canadian Community Health Survey

INTRODUCTION

Disparities in COVID-19 vaccination coverage emerged during the vaccination campaign. This study aimed to assess whether inequalities in COVID-19 vaccination coverage in Canada persisted or resolved throughout the vaccine rollout.

METHODS

Using data from the Canadian Community Health Survey, the analysis included people 18 and older from all ten provinces. Vaccination coverage for at least one dose of a COVID-19 vaccine was determined in three periods: June 2021-February 2022 (n = 28,182), February-June 2022 (n = 25,742), and July-December 2022 (n = 23,119). Statistically significant gaps across groups were assessed using non-overlapping 95 % confidence intervals (CI).

RESULTS

In June 2021-February 2022, coverage for at least one dose (95 % CI) was 85.5 % (79.0-90.3) for off-reserve First Nations people, 85.7 % (79.6-90.1) for Métis people, 79.6 % (72.1-85.4) for Black people, 83.0 % (72.9-89.9) for Arab people, and 92.9 % (92.3-93.5) for White people. By July-December 2022, coverage was 87.4 % (80.2-92.3), 90.5 % (85.5-93.8), 92.1 % (87.2-95.2), 95.6 % (90.6-98.0), and 95.1 % (94.5-95.6), respectively, in the same populations. The gap between off-reserve First Nations and White people remained significant, at 7.4 percentage points (pp.) in the first period and 7.6 pp. in the third period. As for Métis and White people, the gap decreased from 7.3 pp. to 4.6 pp. In the first period, the gap compared to White people was 13.4 pp. for Black people and 9.9 pp. for Arab people, and resolved in the third period. Significant gaps also remained across age groups, levels of educational attainment, household income, for those residing in rural areas, those living with children under 12 years old, and those without a regular healthcare provider.

CONCLUSION

Despite efforts to address them, several inequalities persisted throughout the vaccine rollout, underscoring the need for refined strategies to reach all population segments. As Canadian vaccination registries do not collect sociodemographic data beyond date of birth, sex and place of residence, survey data is needed to measure these disparities.

COVID-19 Vaccine Mandate and Vaccination Rates in the US Military, 2020‒2022

Objectives. To assess the effect of the vaccination mandate on COVID-19 vaccination rates and identify independent factors associated with lack of postmandate vaccination among service members. Methods. We assessed all active component service members for COVID-19 vaccination status from December 11, 2020, to January 1, 2022. We used comparative interrupted time series analysis and logistic regression to compare pre- and postmandate completion of the vaccine series between the US military and the US general population. Results. Previous documented infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), lower rank, and non-Hispanic Black race were associated with lower premandate vaccination. Postmandate vaccination rates were significantly higher in the active component population (P < .001) compared with the premandate period and the US population. Also notable was the higher incidence of postmandate vaccination among those who were non-Hispanic Black or of lower rank. Conclusions. The US military's COVID-19 vaccination mandate was effective at both increasing overall vaccination rates and reducing disparities in vaccination, including race and ethnicity and rank. Vaccine mandates increase the receipt of vaccines and promote health, readiness, and equity within the US military. (Am J Public Health. Published online ahead of print May 15, 2025:e1-e11. https://doi.org/10.2105/AJPH.2025.308120).

Application of an Innovative Methodology to Build Infrastructure for Digital Transformation of Health Systems: Developmental Program Evaluation

BACKGROUND

The current public health crises we face, including communicable disease pandemics such as COVID-19, require cohesive societal efforts to address decision-making gaps in our health systems. Digital health platforms that leverage big data ethically from citizens can transform health systems by enabling real-time data collection, communication, and rapid responses. However, the lack of standardized and evidence-based methods to develop and implement digital health platforms currently limits their application.

OBJECTIVE

This study aims to apply mixed evaluation methods to assess the development of a rapid response COVID-19 digital health platform before public launch by engaging with the development and research team, which consists of interdisciplinary researchers (ie, key stakeholders).

METHODS

Using a developmental evaluation approach, this study conducted (1) a qualitative survey assessing digital health platform objectives, modifications, and challenges administered to 5 key members of the software development team and (2) a role-play pilot with 7 key stakeholders who simulated 8 real-world users, followed by a self-report survey, to evaluate the utility of the digital health platform for each of its objectives. Survey data were analyzed using an inductive thematic analysis approach. Postpilot test survey data were aggregated and synthesized by participant role.

RESULTS

The digital health platform met original objectives and was expanded to accommodate the evolving needs of potential users and COVID-19 pandemic regulations. Key challenges noted by the development team included navigating changing government policies and supporting the data sovereignty of platform users. Strong team cohesion and problem-solving were essential in the overall success of program development. During the pilot test, participants reported positive experiences interacting with the platform and found its features relatively easy to use. Users in the community member role felt that the platform accurately reflected their risk of contracting COVID-19, but reported some challenges interacting with the interface. Those in the decision maker role found the data visualizations helpful for understanding complex information. Both participant groups highlighted the utility of a tutorial for future users.

CONCLUSIONS

Evaluation of the digital health platform development process informed our decisions to integrate the research team more cohesively with the development team, a practice that is currently uncommon given the use of external technology vendors in health research. In the short term, the developmental evaluation resulted in shorter sprints, and the role-play exercise enabled improvements to the log-in process and user interface ahead of public deployment. In the long term, this exercise informed the decision to include a data scientist as part of both teams going forward to liaise with researchers throughout the development process. More interdisciplinarity was also integrated into the research process by providing health system training to computer programmers, a key factor in human-centered artificial intelligence development.

Socioeconomic Differences in Vaccination Coverage After a Mandatory Vaccination Law, 1855-1900

Importance

Mandatory vaccination is a major tool to combat increasing vaccine hesitancy. In principle, a vaccination law, ie, a mandatory vaccination law without exemptions, applies equally to everyone, but its effects across different socioeconomic groups (SEGs) remain unknown.

Objective

To examine the association of a vaccination law with vaccination coverage in different SEGs during 1855 to 1900.

Design, Setting, and Participants

This population-based cohort study monitored 45 years (1855-1900) of Finland's first vaccination campaign against smallpox to estimate the association of the 1883 vaccination law with vaccination coverage in infants (age <1 year) across different SEGs. Data were analyzed from October 2023 to January 2024.

Exposure

A mandatory smallpox vaccination law for all children.

Main Outcomes and Measures

Vaccination status was determined from vaccination records and defined as receiving 1 dose of the smallpox vaccine. The primary outcome was the annual vaccination coverage in different SEGs and its change before vs after the vaccination law.

Results

A total of 40 008 children aged less than 1 year were included. The high SEG had high vaccination coverage, at a mean (SD) of 90% (49 percentage points), and the law was associated with halting its declining trend. For the middle SEG, the law was associated with a 26-percentage point increase in coverage, to a mean (SD) of 83% (50 percentage points). For the low SEG, the law had no association with vaccination coverage, which always remained below 35% (mean [SD]: prelaw, 26% [22 percentage points]; postlaw, 32% [23 percentage points]).

Conclusions and Relevance

In this cohort study, a historic vaccination law was not associated with increased vaccination in the SEG with the lowest vaccination coverage, emphasizing the need for additional interventions to increase vaccine uptake in low-coverage communities.

Did the health care vaccine mandate work? An evaluation of the impact of the COVID-19 vaccine mandate on vaccine uptake and infection risk in a large cohort of Canadian health care workers

BACKGROUND

We aimed to evaluate the impact of health care vaccine mandates on vaccine uptake and infection risk in a cohort of Canadian health care workers (HCWs).

METHODS

We conduct interrupted time series analysis through a regression discontinuity in time approach to estimate the immediate and delayed impact of the mandate. Multilevel mixed effect modeling fitted with restricted maximum likelihood was used to estimate impact on infection risk.

RESULTS

The immediate and sustained effects of the mandate was a 0.19% (P < .05) and a 0.012% (P < .05) increase in the daily proportion of unvaccinated HCWs getting their first dose, respectively. An additional 623 (95% confidence interval: 613-667) HCWs received first doses compared to the predicted uptake absent the mandate. Adjusted test positivity declined by 0.053% (95% confidence interval: 0.035%, 0.069) for every additional day the mandate was in effect.

DISCUSSION

Our results indicate that the mandate was associated with significant increases in vaccine uptake and infection risk reduction in the cohort.

CONCLUSIONS

Given the benefit that vaccination could bring to HCWs, understanding strategies to enhance uptake is crucial for bolstering health system resilience, but steps must be taken to avert approaches that sacrifice trust, foster animosity, or exacerbate staffing constraints for short-term results.

An Interrupted Time Series Analysis of the Impact of the COVID-19 Pandemic on Routine Vaccination Uptake in Kenya

A strategic priority of the World Health Organization's Immunization Agenda 2030 is to increase vaccination coverage and equity through reaching "zero-dose" children. Through an ecological study, we sought to quantify the impact of the COVID-19 pandemic on the coverage of the pentavalent and the measles/rubella vaccines in Kenya, without implying causality. The monthly number of doses from January 2017 to August 2022 were obtained from the Kenya Health Information System for the pentavalent and the measles/rubella vaccines. Immediate (step) and long-term (ramp) changes following interruptions occurring during the period from March 2020 to December 2020 were assessed through an interrupted time series analysis using an autoregressive integrated moving average (ARIMA) model, accounting for seasonality. In December 2020, there was an immediate decrease of 8337, 12,212, and 20,848 in the number of doses for the first, second, and third dose of the pentavalent vaccine, respectively (statistically significant for the third dose only). This corresponded to a percentage relative difference of -21.6, -20.1, and -24.5, respectively, for three doses of pentavalent vaccines, while for measles/rubella vaccine it was -27.3 and -33.6, respectively, for the first and second dose. COVID-19 resulted in interruptions affecting routine immunization, but recovery occurred within four months.

SARS-CoV-2 vaccination in Canadian blood donors: Insight into donor representativeness of the general population

Introduction

Blood donors world-wide were indispensable for monitoring anti-SARS-CoV-2 antibodies generated by infection and vaccination during the pandemic. Prior to the pandemic, donor vaccination behaviours were under-studied. We aimed to compare the percentage of Canadian blood donors with SARS-CoV-2 vaccination antibodies with the percentage of the general population who received at least one dose of vaccine each month during initial vaccine deployment. We also report donor attitudes towards SARS-CoV-2 vaccination.

Methods

Canadian blood donors were randomly selected for SARS-CoV-2 antibody testing over 2021 (N = 165,240). The percentage of donor samples with vaccination antibodies were compared with the percentage of general population who received at least one dose of vaccine in each month of 2021 except February. A random sample of Canadian blood donors were surveyed about vaccination intent and attitudes (N = 4,558 participated, 30.4 % response rate).

Results

The percentages of the general population vaccinated and donors with vaccination antibodies increased from 1 % to over 90 %. General population vaccination was greater early in vaccine deployment than donors (p < 0.05), greater in donors than the general population by mid-2021 (p < 0.05) but they were similar by the end of 2021. While 52.6 % of surveyed donors had received vaccine in May 2021, a further 41.1 % intended to when eligible. Most donors thought COVID-19 infection could be serious (83.5 %) and that it was important to be vaccinated even if previously infected (77.8 %).

Conclusion

Early pandemic vaccine prioritization to at-risk individuals and healthcare workers gave rise to higher general population vaccination percentages, while donors had higher vaccine antibody percentages as vaccine was deployed to progressively younger age groups. Since blood donors may be more willing to receive vaccination, under pandemic conditions they may be valuable for monitoring vaccination-induced seroprevalence.

Impacts of COVID-19 on Intimate Partner Violence Service Provision

COVID-19 policies like stay-at-home orders impacted intimate partner violence (IPV) service provision in Alberta. Using intersectionality and qualitative semi-structured interviews, this article situates IPV and access to services and supports within multiple overlapping factors such as race, gender, class, and ethnic minority status. Two main themes were identified. First, the challenges within IPV service provision reflect the sectors' traditional and binary understanding and response to violence. Second, the move to virtual services brought challenges related to access to telecommunication facilities and zoom fatigue. Thematic analysis also shows the impact of the pandemic in a sector with existing structural/institutional challenges. We conclude by recommending a multi-level intersectional approach to IPV service provision in Alberta.

Assessment of the impact of the vaccine pass policy on COVID-19 vaccine hesitancy and uptake among Chinese adults in Hong Kong

BACKGROUND

Recognising the importance of attaining high vaccine coverage to mitigate the COVID-19 impact, a Vaccine Pass scheme was implemented during and after the first large Omicron wave with high mortality in older ages in Hong Kong in early 2022 requiring three doses by June 2022. We did not identify any studies evaluating the policy impact of vaccination mandates with vaccine uptake over whole policy period of time in a Chinese population. We aim to evaluate the impact of the Vaccine Pass policy on COVID-19 vaccine uptake in adults in a Chinese population in Hong Kong.

METHODS

We analysed patterns in vaccine uptake and hesitancy using local data from population vaccine registry and 32 cross-sectional telephone surveys conducted from October 2021 to December 2022. The association of Vaccine Pass phases with vaccine uptake was examined using logistic regression analyses, taking into account covariates including self-risk perception, perceived self-efficacy in preventing COVID-19 and trust in government in pandemic control as well as physical distancing measures and demographics.

RESULTS

The uptake of primary series and third doses was positively significantly associated with the successive stages of Vaccine Pass implementation (adjusted odds ratios ranged from 2.41 to 7.81). Other statistically significant drivers of uptake included age group, chronic condition, higher perceived personal susceptibility to COVID-19, higher trust in government, and higher educational attainment.

CONCLUSION

Vaccine uptake in older adults was observed to have increased by a greater extent after the policy annoucement and implementation, under the contextual changes during and after a large Omicron wave with high mortality in Hong Kong in early 2022. Since the policy withdrawal the uptake of further booster doses has been very low in all ages. We suggest that improving voluntary booster uptake in older adults should be prioritized.

Public attitudes towards COVID-19 vaccine mandates and vaccine certificates in Canada: a time series study

INTRODUCTION

Since the beginning of the pandemic, numerous public health measures such as COVID-19 vaccines, vaccine mandates and vaccination certificates have been introduced to mitigate the spread of COVID-19. Public opinion and attitudes towards these measures have fluctuated in response to the dynamic political, social, and cultural landscape of the pandemic.

METHODS

We conducted a time-series study consisting of national cross-sectional surveys between November 2021 to March 2022 to evaluate the Canadian public's attitudes towards COVID-19 vaccine mandates and vaccine certificates.

RESULTS

When examining public sentiment towards COVID-19 vaccine certificates and proof of vaccination measures, there was a shift in responses over time. The proportion of participants "strongly supporting" these measures decreased from 66.0 to 43.1% between W25(Capacity Limits), -W32 (Mask Mandate Removed), whereas "strongly oppose" was the second most common response and rose from 15.9 to 20.6% during this same time period. Concurrently, when examining participants views surrounding mandates, many participants believed that their province was reopening at "about the right pace", which remained relatively stable over time (33.0-35.4%) between W28 (Emergency Act)-W32 (Mask Mandate Removed).

CONCLUSION

Our study's findings on the public's attitudes towards COVID-19 vaccine mandates and vaccine certificates in Canada may aid to guide and streamline the implementation of future similar public health interventions. Future research should include extended follow-up and a more comprehensive examination of trust in government institutions and polarized perspectives on vaccine mandates.

Unraveling the association between vaccine attitude, vaccine conspiracies and self-reported side effects following COVID-19 vaccination among nurses and physicians in Jordan

BACKGROUND

The negative impact of vaccine conspiracies is linked with negative health behavior. The aim of the current study was to examine the association between attitudes toward booster COVID-19, influenza, and monkeypox (mpox) vaccinations with post-COVID-19 vaccine side effects, vaccine conspiracies, and attitude towards mandatory vaccination among nurses and physicians in Jordan.

METHODS

A structured closed-ended questionnaire was used to collect data on demographics, COVID-19 history, COVID-19 vaccine type and doses received, self-reported side effects post-COVID-19 vaccination, acceptance of booster COVID-19, seasonal influenza, and mpox vaccinations, attitudes towards mandatory vaccination, and beliefs in vaccine conspiracies.

RESULTS

The study sample comprised a total of 341 participants. Acceptance of yearly booster COVID-19 vaccination was expressed by 46.6% of the sample, while 73.3% accepted seasonal influenza vaccination, and only 37.0% accepted mpox vaccination. A higher frequency of self-reported side effects following the first COVID-19 vaccine dose was associated with embrace of vaccine conspiracies and vaccine type. For the second vaccine dose, a higher frequency of self-reported side effects was associated with the embrace of vaccine conspiracies, older age, and affiliation to private sector. In multinomial logistic regression analyses, the lower embrace of vaccine conspiracies was associated with lower odds of reporting side effects post-COVID-19 vaccination. The lower embrace of vaccine conspiracies and favorable attitude towards mandatory vaccination were associated with the willingness to get COVID-19, influenza, and mpox vaccinations.

CONCLUSION

The study findings highlighted the negative impact of embracing vaccine conspiracies on health-seeking behavior among nurses and physicians. The findings indicated that the willingness to get vaccinated was associated with lower endorsement of vaccine conspiracies. Additionally, the lower embrace of vaccine conspiracies was associated with a lower frequency of self-reported side effects following COVID-19 vaccination. These results emphasize the importance of addressing vaccine misinformation and promoting accurate information to ensure optimal vaccine uptake and public health outcomes.

COVID-19 Vaccine Mandates and Vaccine Hesitancy among Black People in Canada

OBJECTIVES

COVID-19 vaccine mandates increased vaccination rates globally. Implemented as a one-size-fits-all policy, these mandates have unintended harmful consequences for many, including Black Canadians. This article reports findings on the interconnectedness of vaccine mandates and vaccine hesitancy by describing a range of responses to mandatory COVID-19 vaccination policies among Black people in Canada.

METHODS

Using qualitative research methods, semi-structured interviews with 36 Black people living in Canada aged 18 years and over across 6 provinces in Canada were conducted. Participants were selected across intersectional categories including migration status, income, religion, education, sex, and Black ethnicity. Thematic analysis informed the identification of key themes using Foucauldian notions of biopower and governmentality.

RESULTS

Our results show how the power relations present in the ways many Black people actualize vaccine intentions. Two main themes were identified: acceptance of the COVID-19 vaccine in the context of governmentality and resistance to vaccine mandates driven by oppression, mistrust, and religion.

CONCLUSION

COVID-19 vaccine mandates may have reinforced mistrust of the government and decreased confidence in the COVID-19 vaccine. Policy makers need to consider non-discriminatory public health policies and monitor how these policies are implemented over time and across multiple sectors to better understand vaccine hesitancy.

The Impact Of Provincial Proof- Of-Vaccination Policies On Age-Specific First-Dose Uptake Of COVID-19 Vaccines In Canada

Requirements of proof of COVID-19 vaccination were mandated for nonessential businesses and venues by Canada's ten provinces throughout the fall of 2021. Leveraging variations in the timing of these measures across the provinces, we applied event study regression to estimate the impact the announcement of these measures had nationally on age-specific first-dose uptake in the subsequent seven-week period. Proof-of-vaccination mandate announcements were associated with a rapid, significant increase in first-dose uptake, particularly in people younger than age fifty. However, these behavioral changes were short-lived, with uptake returning to preannouncement levels-or lower-in all age groups within six weeks, despite mandates remaining in place for at least four months; this decline occurred earlier and was more apparent among adolescents ages 12-17. We estimated that nationally, 290,168 additional people received their first dose in the seven weeks after provinces announced proof-of-vaccination policies, for a 17.5 percent increase over the number of vaccinations estimated in the absence of these policies. This study provides novel age-specific evidence showing that proof-of-vaccination mandates led to an immediate, significant increase in national first-dose uptake and were particularly effective for increasing vaccination uptake in younger to middle-aged adults. Proof-of-vaccination mandates may be effective short-term policy measures for increasing population vaccination uptake, but their impact may differ across age groups.

The barriers, facilitators and association of vaccine certificates on COVID-19 vaccine uptake: a scoping review

BACKGROUND

Globally, COVID-19 vaccines have proven to be instrumental for promoting population health by reducing illness from SARS-CoV-2. Vaccine certificates emerged as a potentially promising solution for encouraging vaccination and facilitating the safe reopening of society, however, they were controversial due to criticisms of infringing upon individual rights. While there is extensive literature describing the ethical, legal, and public health implications of vaccine certificates, there is currently a gap in knowledge about the association of vaccine certificates on vaccine uptake during the COVID-19 pandemic and barriers and facilitators to their use.

OBJECTIVES

The objectives of this scoping review are to (i) describe the existing literature on the association of vaccine certificates on the rates of COVID-19 vaccine uptake across several countries and (ii) describe the intrinsic and extrinsic barriers or facilitators that moderate this relationship.

METHODS

We conducted a scoping review based on PRISMA Extension for Scoping Reviews (PRSIMA-ScR) guidelines. We searched three bibliographic databases (APA PsychInfo, Embase Classic + Embase, OVID-Medline) and preprint severs during the first week of July 2023. Three reviewers independently screened the studies based on pre-specified eligibility criteria and performed quality assessments of the primary literature and data extraction.

RESULTS

Sixteen studies met the inclusion criteria. 14 or these were surveys and 2 were modelling studies. The majority documented that vaccine certificates were significantly associated with increased rates of COVID-19 vaccine uptake (n = 12), motivated by factors such as travel/employer requirements, influence from the government/peers, and trust in the safety, efficacy, and science behind COVID-19 vaccines. Three studies had non-significant or mixed findings. Only one study found a significant decrease in COVID-19 vaccine uptake, motivated by pervasive distrust in the QR code-based system of digital vaccine certificates in Russia. Quality of survey studies was generally high.

CONCLUSION

Our findings provide insights into the existing literature on vaccine certificates association with vaccine uptake in several different jurisdictions and barriers and facilitators to their uptake. This information can be used to guide future examinations of the implementation of vaccine certificates and more effective implementations.

Herpes zoster and human papillomavirus vaccination opportunities identified using electronic prompts at the time of scheduling influenza or COVID-19 vaccines

Background

Due to workload and competing priorities, vaccination-related interactions in community pharmacies tend to be more reactive than proactive. The aim of this study is to determine the proportion of users of a web-based scheduling system for influenza and COVID-19 vaccines who may be eligible for herpes zoster or human papillomavirus (HPV) vaccination and interested in discussing these vaccines with a pharmacist.

Methods

Individuals scheduling an influenza or COVID-19 vaccine at a pharmacy using the MedEssist platform between October 2021 and March 2022 were asked about their vaccination status against HPV (if aged 9-45) or herpes zoster (if aged ≥50). Those who were unvaccinated or unsure were asked to indicate their willingness to discuss this with a pharmacist. Logistic regression was performed to identify patient characteristics associated with responses to these screening questions.

Results

Among 36,659 bookings by those aged 9 to 45 and 55,728 by those aged ≥50 that included responses to screening questions, 70.1% and 55.5% were potentially unvaccinated against HPV and herpes zoster, respectively, with approximately 1 in 5 also indicating willingness to have a discussion with the pharmacist. Those scheduling appointments for COVID-19 vaccines were significantly less likely to be vaccinated against HPV or herpes zoster and less willing to discuss this with a pharmacist than those seeking influenza vaccination.

Discussion

Automated prompts while booking influenza or COVID-19 vaccinations have the potential to identify vaccine-willing individuals who may benefit from further discussion on their vaccination needs.

Conclusion

Community pharmacies can leverage available technology to support the efficient and effective identification of individuals eligible for vaccination.