C37-02 Sociodemographic Differences in Adherence to Recommended Respiratory Vaccines and the Role of Chronic Respiratory Diseases

Abstract Rationale Chronic obstructive pulmonary disease (COPD) and asthma are leading causes of healthcare burden in US. These two chronic respiratory diseases (CRDs) are characterized by airway inflammation and airflow restriction, pathological processes often worsened by respiratory infections (RIs) leading to increased hospital utilization. Furthermore, individuals with CRDs are more susceptible to RIs, yet adherence to recommended vaccines, influenza, pneumococcal, and COVID-19 remains low. We assess demographic differences in uptake of all three respiratory vaccines (RVs) and investigate the role of CRDs. Methods This is a cross-sectional analysis of the 2023 Behavioral Risk Factor Surveillance System (BRFSS) data. The outcome, adherence, defined as 1) uptake of all three recommended RVs, the annual influenza vaccine, ≥1 dose of the pneumococcal vaccine, and ≥1 dose of the COVID-19 vaccine for respondents ≥50 years and 2) uptake of two RVs, the annual influenza vaccine and ≥1 dose of the COVID-19 vaccine for respondents 50 years. The exposure, history of CRD (hCRD), defined as any self-report of COPD, emphysema, chronic bronchitis and asthma. Weighted descriptive and adjusted multivariable logistic regressions were performed. Results Overall, 136,584 individuals were included, n = 43,293 (18-49 years) and n = 93,291 (≥50 years). The 18-49 group had 18.2% with a hCRDs and 12.5% adherent to all RVs, while the ≥50 group had 19.8% and 15.3%, respectively. Non-Hispanic (NH) White Americans were more adherent than NH Black Americans and Others (18-49 group: 63.9%, 11.9%, 24.2%; ≥50 group: 78.8%, 14.6%, 6.6% ), females males (18-49 group: 56.2%, 43.8%; ≥50 group: 59.1%, 40.8%), those with a college degree or greater less than high school (18-49 group: 48.5%, 5.3%; ≥50 group: 34.0%, 8.2%), married never married (18-49 group: 51.6%, 40.1%; ≥50 group: 59.7%, 7.9%) and hCRD no hCRDs (18-49 group: 13.4%, 12.3%; ≥50 group: 20.7%, 13.9%). Sex, race, education, employment, insurance, personal health provider and comorbidities were significant predictors of adherence in adjusted models for both 18-49 and ≥50 groups. Additionally, hCRD, age group, urban-rural status, marital status, smoking, and cancer were predictors in the model for ≥50 group. Conclusion There is significant variability in adherence to all recommended RVs across sociodemographic characteristics. Individuals ≥50 years were more adherent. History of CRDs influenced adherence in individuals ≥50 years but not those 18-49 years. Multi-prong efforts informed by a life course perspective should be promoted to improve RV uptake behavior earlier in life to help prevent future RI risk, especially in individuals with CRDs. This abstract is funded by: None