Shared and vaccine-specific factors associated with COVID-19 and influenza vaccination intentions among adults in Poland: a COM-B-informed cross-sectional study.
- 1Department of Health Promotion and e-Health, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland.
- 2Department of Pediatrics, Gastroenterology and Nutrition, Medical Faculty, Jagiellonian University Medical College, Krakow, Poland.
Abstract
Introduction
Vaccination intentions reflect both vaccine-specific attitudes and cognitive, social, and practical conditions. This study aimed to identify shared and vaccine-specific factors associated with COVID-19 and influenza vaccination intentions among adults in Poland using a Capability, Opportunity, Motivation-Behavior (COM-B) model-informed comparative approach and to assess the incremental contribution of vaccine hesitancy.Methods
A cross-sectional computer-assisted web survey was conducted in May 2026 among 3,000 adults recruited from a national online panel using quota controls for age, sex, education, place of residence, and macroregion. Measures included a COM-B-informed item set, the Polish Adult Vaccine Hesitancy Scale, the short version of European Health Literacy Survey Questionnaire, the Conspiracy Mentality Questionnaire, and sociodemographic, health-related, political, religious, and social media variables. The item set was evaluated through exploratory and confirmatory factor analyses in independent subsamples, followed by theory-ordered hierarchical logistic regression, post hoc, and sensitivity analyses.Results
Intention was reported by 18.2% of respondents for COVID-19 vaccination and 31.5% for influenza vaccination. Psychometric analyses supported retention of three theory-defined COM-B domain indicators, although Capability and Opportunity showed limited empirical separation. Capability was positively associated with COVID-19 and influenza vaccination intentions (OR = 1.31 and 1.74, respectively), as was Motivation (OR = 2.64 and 1.56). Opportunity showed inverse adjusted associations (OR = 0.72 and 0.73). Vaccine hesitancy added explanatory value in both models and showed a nonlinear association with influenza intention. Political preference showed a vaccine-specific pattern: compared with supporters of Law and Justice, supporters of the far-right Confederation party had lower odds of COVID-19 vaccination intention (OR = 0.50), whereas no corresponding association was observed for influenza vaccination intention. Non-participation in the 2023 parliamentary election was associated with lower odds of both intentions. Nagelkerke R ² values were 0.387 and 0.392, and apparent discrimination was good (AUC = 0.857 and 0.833).Conclusion
The shared pattern across outcomes supports COM-B as an organizing framework, while the incremental contribution of hesitancy and differences in political and health-related correlates demonstrate the vaccine-specific context of vaccination intentions. COVID-19 intention remained more politically differentiated. Vaccination-promotion strategies should combine behavioral diagnosis with attention to the political context of each vaccine.
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BibTeX
@article{duplaga2026shared,
title = {{Shared and vaccine-specific factors associated with COVID-19 and influenza vaccination intentions among adults in Poland: a COM-B-informed cross-sectional study.}},
author = {Mariusz Duplaga and Magdalena Sikorska and Kinga Kowalska-Duplaga},
journal = {Frontiers in public health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1961701},
url = {https://europepmc.org/article/MED/42903207},
note = {CC BY},
}
RIS
TY - JOUR
TI - Shared and vaccine-specific factors associated with COVID-19 and influenza vaccination intentions among adults in Poland: a COM-B-informed cross-sectional study.
AU - Mariusz Duplaga
AU - Magdalena Sikorska
AU - Kinga Kowalska-Duplaga
PY - 2026
DA - 2026/10/06
JO - Frontiers in public health
DO - 10.3389/fpubh.2026.1961701
UR - https://europepmc.org/article/MED/42903207
AB - Introduction Vaccination intentions reflect both vaccine-specific attitudes and cognitive, social, and practical conditions. This study aimed to identify shared and vaccine-specific factors associated with COVID-19 and influenza vaccination intentions among adults in Poland using a Capability, Opportunity, Motivation-Behavior (COM-B) model-informed comparative approach and to assess the incremental contribution of vaccine hesitancy.Methods A cross-sectional computer-assisted web survey was conducted in May 2026 among 3,000 adults recruited from a national online panel using quota controls for age, sex, education, place of residence, and macroregion. Measures included a COM-B-informed item set, the Polish Adult Vaccine Hesitancy Scale, the short version of European Health Literacy Survey Questionnaire, the Conspiracy Mentality Questionnaire, and sociodemographic, health-related, political, religious, and social media variables. The item set was evaluated through exploratory and confirmatory factor analyses in independent subsamples, followed by theory-ordered hierarchical logistic regression, post hoc, and sensitivity analyses.Results Intention was reported by 18.2% of respondents for COVID-19 vaccination and 31.5% for influenza vaccination. Psychometric analyses supported retention of three theory-defined COM-B domain indicators, although Capability and Opportunity showed limited empirical separation. Capability was positively associated with COVID-19 and influenza vaccination intentions (OR = 1.31 and 1.74, respectively), as was Motivation (OR = 2.64 and 1.56). Opportunity showed inverse adjusted associations (OR = 0.72 and 0.73). Vaccine hesitancy added explanatory value in both models and showed a nonlinear association with influenza intention. Political preference showed a vaccine-specific pattern: compared with supporters of Law and Justice, supporters of the far-right Confederation party had lower odds of COVID-19 vaccination intention (OR = 0.50), whereas no corresponding association was observed for influenza vaccination intention. Non-participation in the 2023 parliamentary election was associated with lower odds of both intentions. Nagelkerke R ² values were 0.387 and 0.392, and apparent discrimination was good (AUC = 0.857 and 0.833).Conclusion The shared pattern across outcomes supports COM-B as an organizing framework, while the incremental contribution of hesitancy and differences in political and health-related correlates demonstrate the vaccine-specific context of vaccination intentions. COVID-19 intention remained more politically differentiated. Vaccination-promotion strategies should combine behavioral diagnosis with attention to the political context of each vaccine.
SN - 2296-2565
ER -