Influenza Vaccination Coverage and (SARS-CoV-2) Seroprevalance in a Fire Department

Abstract

Purpose: The confluence of seasonal influenza and COVID-19 disease during Fall 2020 will give rise to considerable morbidity and mortality, likely stressing the U.S. healthcare system. Firefighter/paramedic first responders are at risk of being exposed to pathogens such as coronavirus and the avian flu, that can be transmitted between the patients they serve. We estimate influenza vaccination rates by coronavirus infection status in one large metropolitan Florida career fire department. Methods: We used a cross-sectional study design to estimate flu vaccination prevalence among all frontline firefighter/paramedic workers from a fire department participating in a seroprevalence study. Participants initially provided consent and completed a 76-item web-based survey. Seasonal influenza vaccination was assessed in the 12-months prior to coronavirus testing. Off- and on-duty firefighters/paramedics were subsequently tested for SARS-CoV-2 antibodies using a rapid immunoglobulin (Ig)M-IgG combined lateral flow immunoassay during April/May 2020. Results: Among the 1,555 participating firefighters/paramedics, 8.5% reported receipt of the seasonal flu vaccine, and 4.1% tested SARS-CoV-2 antibody positive. None of the antibody-positive firefighters/paramedics reported receipt of the seasonal influenza vaccine compared to those who tested negative (0.0% vs. 8.5%;p=0.012). After controlling for potential confounders, firefighters/paramedics who were Hispanic/Latino vs non-Hispanic/Latino (Adjusted Odds Ratio, AOR, 0.33 [95% confidence interval=0.20–0.55]), former smokers vs never smokers (AOR:0.47 [0.24-0.93]), and had one or more chronic conditions vs no chronic diseases(AOR:0.33 [0.15-0.75]) were significantly less likely to report seasonal influenza vaccine receipt. Conclusion: Influenza vaccination rates were very low among frontline firefighters/paramedics in a large Florida fire department. Acknowledgements: Research reported in this publication was supported in part by a grant award from the Florida Blue Foundation (PI Caban-Martinez) and by the National Cancer Institute of the National Institutes of Health under Award Number P30CA240139. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Florida Blue Foundation, Blue Cross and Blue Shield of Florida nor the National Institutes of Health.