Seasonal Influenza Vaccination Uptake, Illness and Economic Burden, and Vaccine Information Exposure Among Young Adults in the San Francisco Bay Area.

BACKGROUND

Seasonal influenza prevention in young adults is influenced by access, trust, and vaccine information exposure, but local evidence linking vaccination uptake with illness and economic burden is limited.

METHODS

We conducted a non-probability, cross-sectional electronic survey of adults aged 18-49 years who lived, worked, or studied in the San Francisco Bay Area during the 2025 to 2026 influenza season. Measures included vaccination uptake, influenza-like illness, recovery, functional and economic burden, vaccination sites, and vaccine information exposure. Multivariable logistic regression examined factors associated with vaccination uptake; Kaplan-Meier and Cox models examined time to recovery.

RESULTS

Of 554 responses, 463 were included. Vaccination uptake was 86.2% (n = 399; 95% confidence interval [CI], 82.7-89.2%), likely reflecting a health-engaged convenience sample. Influenza-like illness was reported by 38.4%; median recovery time was 5 days, median missed work or school was 2 days, and median direct out-of-pocket cost was US$20. Prior season vaccination (adjusted odds ratio [aOR], 2.24; 95% CI, 1.15-4.34) and greater trust in Centers for Disease Control and Prevention (CDC) or public health agencies (aOR, 1.46; 95% CI, 1.05-2.02) were associated with vaccination. Pharmacies were the second most common vaccination site and preferred future site.

CONCLUSIONS

Influenza prevention for young adults may benefit from pharmacy-inclusive, multichannel access paired with trusted communication. Findings should be interpreted in light of non-probability recruitment and likely overrepresentation of health-engaged respondents.