Abstract Rationale Chronic obstructive pulmonary disease (COPD) and asthma present varying burden in the United States. Black Americans have a higher prevalence of asthma and experience more disease-related complications, compared to White Americans, while those with COPD report having worse symptoms and health-related quality of life. These chronic respiratory diseases (CRDs) are exacerbated by factors such as respiratory infections, increasing the likelihood of severe symptoms and frequent healthcare utilization. Individuals with CRDs are more susceptible to respiratory infections, yet adherence to the recommended vaccines such as influenza (annually for persons ≥6 months), pneumococcal (single dose in adults ≥50 years), and COVID-19 (≥1 dose for adults ≥19 years) varies. This study investigated the relationship between a history of CRD (hCRD) and respiratory vaccine uptake among Black Americans. We hypothesized that individuals with a hCRD would be more likely to adhere to all three recommended respiratory vaccines compared to those without a hCRD. Methods We analyzed cross-sectional data from a community-based project focused on active case-finding of COPD in Black Americans ≥18 years. Respondents 50 years (n = 29) were excluded due to pneumonia vaccine recommendations not applying to the general population of that age. The outcome was defined as uptake of all three recommended respiratory vaccines (adherence), the annual influenza vaccine, ≥1 dose of the pneumococcal vaccine, and ≥1 dose of the COVID-19 vaccine. The predictor was hCRD, defined as any self-report of COPD, emphysema, chronic bronchitis, active asthma, asymptomatic asthma, and/or childhood asthma. Multivariable binomial logistic regression was applied. Results Of the sample (N = 141), 21.6% (30/139) reported a hCRD and 36.2% (51/140) were up to date on all three vaccines. More participants with a hCRD had received vaccines for influenza (72.4% vs. 52.3%, p = 0.053), pneumonia (73.3% vs. 43.8%, p = 0.004) and COVID-19 (90.1% vs. 89.6%, p = 0.095). Adherence to vaccines was also higher, hCRD, 56.7% vs. no hCRD, 30.6%, p = 0.009. Participants with a hCRD and those with ≥2 comorbidities had significantly higher odds of being adherent, UOR 2.97 95% C.I., 1.30-6.82 and UOR 6.79 95% C.I., 1.57-29.4, respectively. The significant relationships were not maintained after controlling for sociodemographic and health-related factors. Conclusion Individuals with hCRD were more adherent to the recommended respiratory vaccines. History of CRD and having two or more comorbidities were significant predictors of adherence in the unadjusted model. This study highlights a need for comprehensive and integrated vaccine promotion in minority populations, particularly those at risk for CRDs. This abstract is funded by: CHEST Foundation
Overholt et al. (2026) studied this question.