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

Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.