Health Worker Influenza Vaccination Programs: A Key to Pandemic Preparedness and Effective COVID-19 Vaccine Deployment in Low- and Middle-Income Countries

Background/Objectives: The COVID-19 pandemic presented an urgent global need to quickly vaccinate health workers (HWs). We used this unique circumstance to assess whether mature influenza vaccination programs for HWs facilitated rapid deployment of COVID-19 vaccines in low- and middle-income countries (LMICs). Methods: We used publicly available population-level COVID-19 vaccination coverage data from the World Health Organization (WHO) COVID-19 PowerBI Dashboard for 60 LMICs to investigate general population coverage with the COVID-19 vaccine over the first year of vaccine rollout. We also evaluated country-level policy and program data reported to the WHO–United Nations Children’s Fund (UNICEF) electronic Joint Reporting Form (eJRF) in 2022 or earlier to determine if the presence of a mature (≥2 years of influenza vaccine introduction in HWs prior to 2019) HW influenza vaccination program was associated with more rapid COVID-19 vaccine deployment and/or pandemic preparedness. We used a mixed-effects beta regression model to investigate whether having a mature HW influenza vaccination program was associated with COVID-19 vaccination coverage levels and/or deployment timeliness. Finally, to provide a better understanding of the possible relationship between the presence of a mature HW influenza vaccination program and the COVID-19 vaccine rollout, we analyzed interview data collected during COVID-19 vaccine post-introduction evaluations (cPIEs). Results: Twenty-four of our study countries (40%) had mature HW influenza vaccination programs prior to the COVID-19 pandemic, and 16 (27%) participated in cPIEs. The overall adjusted mean general-population COVID-19 vaccination coverage at 12 months post-deployment in countries with mature HW influenza vaccination programs was 46% (95% CI: (35%, 56%)), compared with 25% (95% CI: (19%, 32%)) in countries without such programs. Vaccination coverage was 2.5 times higher in countries with mature programs (adjusted odds ratio 2.5, 95% CI: (1.5, 4.5); p = 0.001). Conclusions: Our analysis suggests that mature influenza vaccination programs for HWs were associated with timelier and more complete COVID-19 vaccination rollout.