COVID-19 vaccine uptake in US adults with respiratory diseases: A cross-sectional study.

Publication date: Apr 01, 2026

Despite their proven effectiveness, COVID-19 vaccination rates remain low, particularly among individuals with respiratory diseases. We aimed to examine factors associated with vaccine uptake, focusing on respiratory conditions and prior respiratory vaccination history. We conducted a cross-sectional analysis using 2022 data from the Medical Expenditure Panel Survey. We used logistic regression to examine the association between COVID-19 vaccine uptake and various socioeconomic factors, respiratory conditions, and prior influenza vaccination in US adults. Of 18,155 participants, 3083 (16. 98%) were unvaccinated and 15,072 (83. 02%) vaccinated. Unvaccinated individuals were more likely younger, male, non-Hispanic Black, immigrants, lower-income, less educated, Southern residents, and smokers. Prior influenza (OR = 1. 82, 95% CI [1. 39, 2. 42]) and pneumonia vaccination (OR = 2. 55, 95% CI [2. 14, 3. 04]) were linked to higher COVID-19 vaccination. Among those with respiratory disease, prior influenza (OR = 1. 78, 95% CI [1. 05, 3. 21]) and pneumonia vaccination (OR = 2. 09, 95% CI [1. 50, 2. 94]) predicted greater uptake. The highest rates were in individuals vaccinated for both (OR = 4. 79, 95% CI [2. 51, 9. 37]). Respiratory diseases themselves were not significant predictors. Prior vaccination history and socioeconomic status are stronger predictors of COVID-19 vaccine uptake than respiratory disease history. Enhancing routine immunization and reducing socioeconomic disparities may improve coverage better than disease-specific approaches.

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