Sociopolitical and health-related determinants of COVID-19 vaccine uptake in Poland

Background

COVID-19 vaccination remains a useful case for examining how social positioning, political alignment, and perceived health risk shape adult immunization behavior beyond the emergency phase of the pandemic. This study aimed to identify sociopolitical and health-related determinants of COVID-19 vaccine uptake among adult Internet users in Poland.

Methods

Data came from a nationwide quota-controlled online survey conducted in December 2024 among Internet users aged 18-75 years in Poland (N = 2,200). The outcome was self-reported receipt of at least one COVID-19 vaccine dose. Logistic regression was used to assess associations with sociodemographic characteristics, political sympathies, health-related variables, and religious practices. Results are reported as adjusted odds ratios (ORs) with 95%CI. The analysis was conducted within the EUVABECO project (No 101132545; 5786/EU4Health/2024/2).

Results

The analytic sample included 1,800 respondents; 1,170 (65.0%) reported at least one COVID-19 vaccine dose. The model was significant (χ²(34)=215.92, p < 0.001, Nagelkerke R²=0.156). Older age was associated with higher uptake (OR = 1.02 per year, 95%CI 1.01-1.03). Compared with supporters of the main right-wing party, supporters of the main centrist party had higher odds of uptake (OR = 2.01, 95%CI 1.44-2.81). The presence of chronic disease was also associated with higher uptake (OR = 1.40, 95%CI 1.10-1.77). Respondents with the highest attendance to religious practices showed lower uptake compared to non-believers (OR = 0.71, 95%CI 0.51-0.99). Additional significant contrasts were observed for attained education, income, marital status, and self-rated health.

Conclusions

COVID-19 vaccine uptake in the post-pandemic period reflects intertwined political, social, religious, and health-related determinants. Vaccination strategies should move beyond uniform messaging and align risk communication with the sociopolitical contexts in which vaccine decisions are made.

Key messages

• COVID-19 vaccine uptake was linked to political sympathies, religious practices, social position, and perceived health relevance.

• Adult vaccination strategies should move beyond uniform messaging and adapt risk communication to sociopolitical contexts.