---
title: "Gaps Between Willingness and Uptake of Influenza and COVID-19 Vaccines in a U.S. Adult Cohort (202"
id: "pubmed-42702142"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42702142"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42702142/"
doi: "10.1016/j.vaccine.2026.129126"
published_at: "2026-10-24T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Gaps Between Willingness and Uptake of Influenza and COVID-19 Vaccines in a U.S. Adult Cohort (202
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42702142
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42702142/)
- **DOI:** [10.1016/j.vaccine.2026.129126](https://doi.org/10.1016%2Fj.vaccine.2026.129126)
- **Published At:** 2026-10-24T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The study analyzed responses from 3,390 adults in the CHASING COVID Cohort who completed surveys in August 2025 and March 2026 to measure differences between stated intention and actual vaccination for the 2025–26 respiratory virus season. - Investigators defined **vaccine willingness** using prior-season vaccination and expressed intention to vaccinate during the 2025–26 season. - In August 2025, 73% of participants were willing to receive the **influenza** vaccine; 68% were willing to receive the **COVID-19** vaccine. - By March 2026, among those who were willing in August, 17% remained unvaccinated for **influenza** and 39% remained unvaccinated for **COVID-19**, indicating substantial drop-off between intention and action. - Absence of prior-season vaccination was the strongest predictor of not vaccinating for both viruses (adjusted risk ratios reported in the source). - Additional predictors associated with non-vaccination included food insecurity, any healthcare barrier, and reporting no confidence in vaccine safety; the source provided adjusted risk ratios for these associations. - Trajectory analyses indicated some participants simply failed to follow through on intentions, while others represented discontinuation among previous vaccinators. - Commonly reported reasons for non-vaccination among willing participants included difficulty finding a convenient time, place, or appointment; for **COVID-19**, lack of a healthcare provider recommendation was also commonly cited. - Authors noted missed opportunities among adults who were previously vaccinated or open to vaccination and suggested interventions focused on reinforcing confidence, reducing logistical and access barriers, and making vaccination easier to complete.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 6. # Gaps between willingness and uptake of influenza and COVID-19 vaccines during the 2025-26 respiratory virus season in a U.S. adult cohort [Jenna Sanborn](https://pubmed.ncbi.nlm.nih.gov/?term=Sanborn+J&cauthor_id=42702142)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42702142/#full-view-affiliation-1 "Institute for Implementation Science in Population Health, New York, NY, USA; Department of Epidemiology & Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, USA. Electronic address: jenna.sanborn@sph.cuny.edu."), [McKaylee M Robertson](https://pubmed.ncbi.nlm.nih.gov/?term=Robertson+MM&cauthor_id=42702142)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42702142/#full-view-affiliation-2 "Institute for Implementation Science in Population Health, New York, NY, USA; Department of Epidemiology & Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, USA."), [Kate Penrose](https://pubmed.ncbi.nlm.nih.gov/?term=Penrose+K&cauthor_id=42702142)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42702142/#full-view-affiliation-3 "Institute for Implementation Science in Population Health, New York, NY, USA."), [Madhura Rane](https://pubmed.ncbi.nlm.nih.gov/?term=Rane+M&cauthor_id=42702142)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42702142/#full-view-affiliation-3 "Institute for Implementation Science in Population Health, New York, NY, USA."), [Rachael Piltch-Loeb](https://pubmed.ncbi.nlm.nih.gov/?term=Piltch-Loeb+R&cauthor_id=42702142)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42702142/#full-view-affiliation-4 "Institute for Implementation Science in Population Health, New York, NY, USA; Department of Environmental Occupational Geospatial Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, USA."), [Angela M Parcesepe](https://pubmed.ncbi.nlm.nih.gov/?term=Parcesepe+AM&cauthor_id=42702142)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42702142/#full-view-affiliation-5 "University of North Carolina at Chapel Hill Gillings School of Public Health and Carolina Population Center, Chapel Hill, NC, USA."), [Denis Nash](https://pubmed.ncbi.nlm.nih.gov/?term=Nash+D&cauthor_id=42702142)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42702142/#full-view-affiliation-2 "Institute for Implementation Science in Population Health, New York, NY, USA; Department of Epidemiology & Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, USA.") Affiliations Expand ### Affiliations * 1 Institute for Implementation Science in Population Health, New York, NY, USA; Department of Epidemiology & Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, USA. Electronic address: jenna.sanborn@sph.cuny.edu. * 2 Institute for Implementation Science in Population Health, New York, NY, USA; Department of Epidemiology & Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, USA. * 3 Institute for Implementation Science in Population Health, New York, NY, USA. * 4 Institute for Implementation Science in Population Health, New York, NY, USA; Department of Environmental Occupational Geospatial Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, USA. * 5 University of North Carolina at Chapel Hill Gillings School of Public Health and Carolina Population Center, Chapel Hill, NC, USA. * PMID: **42702142** * DOI: [ 10.1016/j.vaccine.2026.129126 ](https://doi.org/10.1016/j.vaccine.2026.129126) Free article Item in Clipboard # Gaps between willingness and uptake of influenza and COVID-19 vaccines during the 2025-26 respiratory virus season in a U.S. adult cohort Jenna Sanborn et al. Vaccine. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Vaccine Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Vaccine%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Vaccine%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42702142/) . 2026 Oct 24:92:129126. doi: 10.1016/j.vaccine.2026.129126. Epub 2026 Sep 6. ### Authors [Jenna Sanborn](https://pubmed.ncbi.nlm.nih.gov/?term=Sanborn+J&cauthor_id=42702142)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42702142/#short-view-affiliation-1 "Institute for Implementation Science in Population Health, New York, NY, USA; Department of Epidemiology & Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, USA. Electronic address: jenna.sanborn@sph.cuny.edu."), [McKaylee M Robertson](https://pubmed.ncbi.nlm.nih.gov/?term=Robertson+MM&cauthor_id=42702142)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42702142/#short-view-affiliation-2 "Institute for Implementation Science in Population Health, New York, NY, USA; Department of Epidemiology & Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, USA."), [Kate Penrose](https://pubmed.ncbi.nlm.nih.gov/?term=Penrose+K&cauthor_id=42702142)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42702142/#short-view-affiliation-3 "Institute for Implementation Science in Population Health, New York, NY, USA."), [Madhura Rane](https://pubmed.ncbi.nlm.nih.gov/?term=Rane+M&cauthor_id=42702142)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42702142/#short-view-affiliation-3 "Institute for Implementation Science in Population Health, New York, NY, USA."), [Rachael Piltch-Loeb](https://pubmed.ncbi.nlm.nih.gov/?term=Piltch-Loeb+R&cauthor_id=42702142)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42702142/#short-view-affiliation-4 "Institute for Implementation Science in Population Health, New York, NY, USA; Department of Environmental Occupational Geospatial Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, USA."), [Angela M Parcesepe](https://pubmed.ncbi.nlm.nih.gov/?term=Parcesepe+AM&cauthor_id=42702142)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42702142/#short-view-affiliation-5 "University of North Carolina at Chapel Hill Gillings School of Public Health and Carolina Population Center, Chapel Hill, NC, USA."), [Denis Nash](https://pubmed.ncbi.nlm.nih.gov/?term=Nash+D&cauthor_id=42702142)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42702142/#short-view-affiliation-2 "Institute for Implementation Science in Population Health, New York, NY, USA; Department of Epidemiology & Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, USA.") ### Affiliations * 1 Institute for Implementation Science in Population Health, New York, NY, USA; Department of Epidemiology & Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, USA. Electronic address: jenna.sanborn@sph.cuny.edu. * 2 Institute for Implementation Science in Population Health, New York, NY, USA; Department of Epidemiology & Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, USA. * 3 Institute for Implementation Science in Population Health, New York, NY, USA. * 4 Institute for Implementation Science in Population Health, New York, NY, USA; Department of Environmental Occupational Geospatial Health, Graduate School of Public Health and Health Policy, The City University of New York, New York, USA. * 5 University of North Carolina at Chapel Hill Gillings School of Public Health and Carolina Population Center, Chapel Hill, NC, USA. * PMID: **42702142** * DOI: [ 10.1016/j.vaccine.2026.129126 ](https://doi.org/10.1016/j.vaccine.2026.129126) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract During the 2025-26 respiratory virus season, changes to COVID-19 vaccine eligibility, recommendations, and communication may have made vaccination follow-through especially challenging. Under-vaccination may reflect not only lack of willingness, but also breakdowns between willingness and uptake. We analyzed data from 3390 adults in the CHASING COVID Cohort who completed assessments in August 2025 and March 2026 to examine gaps between vaccine willingness and subsequent influenza and COVID-19 vaccination. Vaccine willingness was defined using prior-season vaccination and stated intention to vaccinate during the 2025-26 respiratory virus season. In August 2025, 73% of participants were influenza vaccine willing and 68% were COVID-19 vaccine willing. Among vaccine-willing participants, 17% and 39% were unvaccinated for influenza and COVID-19, respectively, by March 2026. Absence of prior-season vaccination was the strongest predictor of not vaccinating for influenza and COVID-19, respectively (aRR [95% CI]: 4.04 [3.44-4.74]; 3.01 [2.72-3.34]). Non-vaccination was also associated with food insecurity (1.99 [1.66-2.37]; 1.47 [1.33-1.63]), any healthcare barrier (1.89 [1.57-2.28]; 1.51 [1.36-1.67]), and being not at all confident in vaccine safety (2.95 [2.15-4.05]; 2.21 [1.88-2.59]). Trajectory analyses suggested willingness-uptake gaps reflected incomplete follow-through on intentions and discontinuation among some prior vaccinators. Commonly reported reasons among vaccine-willing non-vaccinators included difficulty finding a convenient time, place, or appointment and, for COVID-19, lack of healthcare provider recommendation. Findings among non-vaccinated adults with prior or stated openness to vaccinate highlight missed opportunities and suggest avenues to improve coverage through strategies that reinforce vaccine confidence, reduce access and logistical barriers, and make vaccination easier to complete. **Keywords:** Adult vaccination; COVID-19 vaccination; Influenza vaccination; Vaccine hesitancy; Vaccine uptake; Vaccine willingness. Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Denis Nash reports financial support was provided by Pfizer. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The City University of New York (CUNY) School of Public Health received research support from Pfizer during the conduct of this study which was paid directly to CUNY, with Dr. Nash serving as the Principal Investigator. ## Similar articles * [ Willingness among adults in the United States to receive a combination influenza and COVID-19 vaccine. ](https://pubmed.ncbi.nlm.nih.gov/40643200/) Summers RJ, Katz ML, Reiter PL.Summers RJ, et al.Hum Vaccin Immunother. 2025 Dec;21(1):2532272. doi: 10.1080/21645515.2025.2532272. Epub 2025 Jul 11.Hum Vaccin Immunother. 2025.PMID: 40643200Free PMC article. * [ Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021-22 Influenza Season. ](https://pubmed.ncbi.nlm.nih.gov/34448800/) Grohskopf LA, Alyanak E, Ferdinands JM, Broder KR, Blanton LH, Talbot HK, Fry AM.Grohskopf LA, et al.MMWR Recomm Rep. 2021 Aug 27;70(5):1-28. doi: 10.15585/mmwr.rr7005a1.MMWR Recomm Rep. 2021.PMID: 34448800Free PMC article. * [ Impact of propensity to COVID-19 vaccination/vaccine on influenza vaccination from willingness to behavior among older adults in rural China. ](https://pubmed.ncbi.nlm.nih.gov/39539085/) Zhang SS, Shi W, Du J, Zhang WX, Yuan M, Zhou Y, Wang L, Zhao T, Ma QY, Zhang S, Yang H, Zhang X, Wang M, Huang N, Zeng J, Liu Y, Zhang Y, Cui F, Lu QB.Zhang SS, et al.Hum Vaccin Immunother. 2024 Dec 31;20(1):2428017. doi: 10.1080/21645515.2024.2428017. Epub 2024 Nov 13.Hum Vaccin Immunother. 2024.PMID: 39539085Free PMC article. * [ Impact of COVID-19 on vaccine confidence and uptake: A systematic literature review. ](https://pubmed.ncbi.nlm.nih.gov/39106971/) Vojtek I, van Wouw M, Thomson A.Vojtek I, et al.Hum Vaccin Immunother. 2024 Dec 31;20(1):2384180. doi: 10.1080/21645515.2024.2384180. Epub 2024 Aug 6.Hum Vaccin Immunother. 2024.PMID: 39106971Free PMC article. * [ Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2022-23 Influenza Season. ](https://pubmed.ncbi.nlm.nih.gov/36006864/) Grohskopf LA, Blanton LH, Ferdinands JM, Chung JR, Broder KR, Talbot HK, Morgan RL, Fry AM.Grohskopf LA, et al.MMWR Recomm Rep. 2022 Aug 26;71(1):1-28. d
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