Publication date: Jun 27, 2026
To examine rural-urban differences in vaccination against COVID-19 and influenza since the introduction of the COVID-19 vaccine. Our analysis used the National Health Interview Survey from April 2021-December 2023, including respondents ≥18 years. The outcome was past 12-month vaccination, categorized as vaccination against only influenza, only COVID-19, both, or neither. The primary exposure was rural-urban classification. Multinomial logistic regression modeled vaccination according to rural-urban classification with interaction terms between rural-urban classification and time (months). Another model added a binary control for the end of the public health emergency in May 2023 and its interaction between rural-urban classification. Over our study period, receipt of both vaccines decreased (42% to 28%). On multivariable regression, rural compared to urban respondents had a lower likelihood of receiving both vaccines (relative risk ratio:0. 61; 95% confidence interval:0. 52,0. 71; p
| Concepts | Keywords |
|---|---|
| December | COVID-19 vaccination |
| Influenza | Immunizations |
| Rural | Influenza vaccination |
| Vaccination | Rural health |
| United States |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | influenza |
| disease | MESH | COVID-19 |
| disease | MESH | emergency |