ArticleFrontiers in public health2026
Urban-rural and comorbidity-related differences in vaccination attitudes and self-reported adverse events following immunisation in Poland: a cross-sectional primary care study.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Vaccination attitudes and uptake are shaped by sociodemographic context, geography, and health status. How comorbidities and prior infection experiences interact with place of residence to influence vaccine decision-making remains insufficiently characterized in Polish primary care settings. Objective: To compare vaccination attitudes, self-reported adverse events following immunisation (AEFI), and determinants of vaccination across large-city, small-city, and rural primary care populations in Poland, with particular attention to comorbidities and prior infectious disease experiences. Methods: We conducted a cross-sectional study using questionnaire data linked to primary care records in three primary healthcare centres representing a large city, a small-to-medium city, and a rural setting. Group differences were assessed with contingency tables and Pearson's chi-square tests (two-sided alpha 0.05). Multivariable logistic regression modeled uptake of influenza, COVID-19, and pertussis vaccination using comorbid respiratory, circulatory, and metabolic conditions and prior infection history as predictors. Results: Vaccination coverage differed markedly by setting ( Conclusion: Vaccination attitudes, uptake, and self-reported AEFIs differ substantially between urban and rural primary care settings in Poland. Respiratory comorbidity and prior infection experiences consistently predict vaccine uptake, underscoring the need for geographically tailored communication strategies and risk framing that reflects local context and chronic disease burden.
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