{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T12:49:08Z","timestamp":1793796548633,"version":"4.6.1"},"posted":{"date-parts":[[2026,5,28]]},"group-title":"Public and Global Health","reference-count":45,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"SHIELD Illinois"},{"name":"National Institute of General Medical Sciences of the National Institutes of Health","award":["R35GM156856"],"award-info":[{"award-number":["R35GM156856"]}]},{"name":"National Science Foundation","award":["DMS-2436332"],"award-info":[{"award-number":["DMS-2436332"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,5,28]]},"abstract":"<jats:label>1<\/jats:label>\n                <jats:title>Abstract<\/jats:title>\n                <jats:p>While SARS-CoV-2 and influenza continue to place a significant burden on population health, within-household differences in decisions towards vaccination and seeking care across these two pathogens, and across sociodemographic groups, remain largely unexplored. By conducting a household-level survey in Illinois, we found that many individuals made inconsistent decisions about vaccination: among all adults, 29% were vaccinated for only one of COVID-19 or influenza, and among those with children in the home, 39% lived with a child whose influenza or COVID-19 vaccination status differed from their own. A higher proportion of adults were vaccinated against COVID-19 compared to influenza, while the opposite was true for those younger than 18 years old. These differences hold even when accounting for disparities in coverage by age, race\/ethnicity, political affiliation, and socioeconomic status. While vaccinated individuals consistently reported wanting to protect themselves or others, those who declined vaccination reported highly hetero-geneous reasons ranging from resource constraints to distrust or misconceptions about vaccination. These differences are even more pronounced for COVID-19, with larger partisan gaps and higher refusal driven by safety concerns, lack of trust, or religious reasons than those who decide not to get the influenza vaccine. In contrast to vaccination, the decision to seek medical care when sick showed opposite sociodemographic trends, that are likely attributable to illness severity. Our findings highlight that closing gaps in COVID-19 and influenza vaccination coverage will require an integrative strategy that accounts for diverse motivations, fears, and barriers to access, while addressing social inequalities common to both diseases.<\/jats:p>","DOI":"10.64898\/2026.05.26.26354179","type":"posted-content","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T22:15:13Z","timestamp":1780006513000},"source":"Crossref","is-referenced-by-count":2,"title":["Same household, different choices: variation in health behaviors related to respiratory viruses in Illinois"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3409-3447","authenticated-orcid":false,"given":"Soren L.","family":"Larsen","sequence":"first","affiliation":[{"name":"Department of Demography, University of California Berkeley, Berkeley, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junke","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin M.","family":"Haslett","sequence":"additional","affiliation":[{"name":"Department of Political Science, University of Illinois Urbana-Champaign, Urbana, IL, USA"},{"name":"Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Anastasi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Venegas","sequence":"additional","affiliation":[{"name":"Department of Mathematics, University of Illinois Urbana-Champaign, Urbana, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Schieleit","sequence":"additional","affiliation":[{"name":"Department of Statistics, University of Illinois Urbana-Champaign, Urbana, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2282-8613","authenticated-orcid":false,"given":"Ayesha S.","family":"Mahmud","sequence":"additional","affiliation":[{"name":"Department of Demography, University of California Berkeley, Berkeley, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3607-0938","authenticated-orcid":false,"given":"Pamela P.","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Statistics, University of Illinois Urbana-Champaign, Urbana, IL, USA"},{"name":"Department of Microbiology, University of Illinois Urbana-Champaign, Urbana, IL, USA"},{"name":"Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026060100051120000_2026.05.26.26354179v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2007.03.046"},{"issue":"10","key":"2026060100051120000_2026.05.26.26354179v1.2","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1001\/jamainternmed.2020.3391","article-title":"Estimation of excess deaths associated with the covid-19 pandemic in the united states, march to may 2020","volume":"180","year":"2020","journal-title":"JAMA internal medicine"},{"key":"2026060100051120000_2026.05.26.26354179v1.3","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2313661121"},{"issue":"1","key":"2026060100051120000_2026.05.26.26354179v1.4","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1186\/s12939-021-01582-4","article-title":"A systematic review of racial\/ethnic and socioeconomic disparities in covid-19","volume":"20","year":"2021","journal-title":"International journal for equity in health"},{"key":"2026060100051120000_2026.05.26.26354179v1.5","doi-asserted-by":"crossref","first-page":"101314","DOI":"10.1016\/j.ssmph.2022.101314","article-title":"Health disparities in past influenza pandemics: a scoping review of the literature","volume":"21","year":"2023","journal-title":"SSM-population health"},{"key":"2026060100051120000_2026.05.26.26354179v1.6","doi-asserted-by":"publisher","DOI":"10.1126\/science.abg5298"},{"key":"2026060100051120000_2026.05.26.26354179v1.7","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1186\/s12889-021-11177-x","article-title":"Geographic and demographic heterogeneity of sars-cov-2 diagnostic testing in illinois, usa, march to december 2020","volume":"21","year":"2021","journal-title":"BMC Public Health"},{"key":"2026060100051120000_2026.05.26.26354179v1.8","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.adh9920"},{"issue":"36","key":"2026060100051120000_2026.05.26.26354179v1.9","doi-asserted-by":"crossref","first-page":"5322","DOI":"10.1016\/j.vaccine.2023.07.022","article-title":"Social inequalities and the early provision and dispersal of covid-19 vaccinations in the united states: A population trends study","volume":"41","year":"2023","journal-title":"Vaccine"},{"key":"2026060100051120000_2026.05.26.26354179v1.10","doi-asserted-by":"crossref","first-page":"106282","DOI":"10.1016\/j.ypmed.2020.106282","article-title":"Covid-19 treatment resource disparities and social disadvantage in new york city","volume":"141","year":"2020","journal-title":"Preventive Medicine"},{"key":"2026060100051120000_2026.05.26.26354179v1.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2010.02904.x"},{"key":"2026060100051120000_2026.05.26.26354179v1.12","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-11179-9"},{"key":"2026060100051120000_2026.05.26.26354179v1.13","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2009.188029"},{"key":"2026060100051120000_2026.05.26.26354179v1.14","doi-asserted-by":"crossref","unstructured":"Kerri-Ann M Anderson , Glen J Nowak , Michael A Cacciatore , Pejman Rohani , and John M Drake . 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