Vaccine fatigue and influenza vaccination trends across Pre-, Peri-, and Post-COVID-19 periods in the United States using epic’s cosmos database

Post-pandemic influenza vaccination compliance decreased relative to pre-pandemic, especially among younger age groups, certain racial groups, and in the southern U.S. These findings suggest that the COVID-19 pandemic negatively impacted influenza vaccination compliance. While overall trends aligned with publicly available data, absolute counts may be under-reported within Epic due to incomplete documentation of vaccine administrations outside of Epic-affiliated systems.