Influenza vaccine uptake among youth with sickle cell disease who are seen in clinic before and after the COVID-19 pandemic

Influenza vaccination is critical for children with sickle cell disease (SCD) due to risks of severe influenza infections. Despite declining influenza vaccination among children since the COVID-19 pandemic, less is known about influenza vaccine coverage among youth with SCD during this same period. We compared influenza vaccine uptake among youth with SCD seen by a SCD provider in clinic during the 2019–2020 and 2022–2023 influenza seasons and described infection characteristics. Overall, 85% (n = 220) of children received their influenza vaccine during 2019–2020 compared to 75% (n = 245) in 2022–2023 (p = 0.059). Participants seen during both seasons were more likely to shift from vaccinated in 2019–2020 to unvaccinated in 2022–2023 than vice versa (McNemar's OR = 3.0; p = 0.008). Among 66 documented infections, 25.8% resulted in hospitalization. We found high influenza vaccine uptake but those seen during both seasons were more likely to become unvaccinated. More research is needed to understand influenza vaccine decision-making in this population. •Influenza vaccine uptake among youth with sickle cell disease (SCD) seen for care before and after the pandemic was relatively high.•Youth with SCD were more likely to shift from influenza vaccinated to unvaccinated after the pandemic.•One in four documented influenza infections among youth with SCD resulted in a hospitalization.•Future work should examine drivers of vaccine decision-making in this population.