Influenza Vaccination Coverage Among English-Speaking Asian Americans

Abstract

Introduction: English-speaking non-Hispanic Asians (Asians) in the U.S. include populations with multiple geographic origins and ethnicities (e.g., Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese). Health behaviors and outcomes can differ widely among Asian ethnicities, and highlight the importance of subgroup analysis. Aggregating Asians may mask differences in influenza vaccination across various ethnicities. Methods: Combined data from 2013 to 2015 Behavioral Risk Factor Surveillance System, a population-based, telephone survey of the non-institutionalized, U.S. population aged ≥ 18 years, were analyzed in 2017 to assess influenza vaccination among Asians. Weighted proportions were calculated. Multivariable logistic regression was used to determine independent associations between sociodemographic factors and receipt of influenza vaccination. Results: Influenza vaccination varied widely among Asian ethnicities, both nationally and by state. Overall, 42.1% of Asians reported having received an influenza vaccine, similar to vaccination among whites (42.4%). Coverage ranged from 36.1% among Koreans to 50.9% among Japanese. Factors independently associated with influenza vaccination among some or all Asian ethnicities included age (≥ 50 years), female, never married, high school or higher education, annual household income ≥ $75,000, possession of medical insurance and personal healthcare provider, routine checkup in the previous year, and presence of certain chronic conditions. Conclusions: Though Asians and whites had similar overall influenza vaccination coverage, differences existed between Asian ethnicities, both nationally and by state. This information may help community-based, state-level, and national-level public health agencies to support targeted approaches for outreach to these populations, such as improving cultural and linguistic access to care, to improve influenza vaccination.

Associations between Influenza Vaccination and Health Care Access among Adults in the United States

“…Black and AIAN respondents were less likely than White respondents to receive the influenza vaccine. These findings are also congruent with the established literature [ 34 , 35 , 36 , 37 , 38 ]. Although NHPI respondents reported slightly lower vaccination uptake than White respondents, the difference was not statistically significant.…”

Effects of Patient-Centered Communication on Influenza Vaccination and Self-Reported General Health Status among Asian Americans: A Comparison Model for Young/Middle-Aged and Older Adults

“…When we look at each racial/ethnic minority group separately, startling low rates of influenza vaccination were found in 2017: 28.4% for Hispanic, 32.3% for non-Hispanic black, 33.1% for American Indian/Alaska native, 40.2% for non-Hispanic white, and 42% for Asian American adults (Centers for Disease Control and Prevention, 2018). This is similar to the data from the Behavioral Risk Factor Surveillance System for 2013–2015 (Srivastav et al, 2018). Even with the fact that none of the racial/ethnic groups could approach the average percentage on flu vaccination, not many prior studies have focused on identifying risk factors for low vaccination among Asian Americans.…”

Social determinants of flu vaccine uptake among racial/ethnic minorities in the United States

“…The demographics associated with flu vaccination uptake in the US adult general population are well established – studies have found that race/ethnicity, age, sex, socio-economic-status (SES), insurance, having a usual source of care, contact with physicians, health behaviors, health status, and receipt of other vaccinations, and beliefs are associated with flu vaccine uptake ( Kamis et al, 2017 , Lu et al, 2015 , Schmid et al, 2017 , Takayama et al, 2012 , Williams et al, 2017 ). The majority of literature examining correlates of vaccine uptake compare racial ethnic groups to non-Hispanic (NH) whites ( Budhwani and De, 2016 , Hughes et al, 2019 , Lu et al, 2017 , Lu et al, 2015 , Srivastav et al, 2018 , Stafford et al, 2013 , Tse et al, 2018 ). The existing studies which examine flu vaccine uptake within specific US racial/ethnic groups are of limited generalizability due to the fact that they focus on the population of individual states or localities ( Bazargan et al, 2020 , Cohen et al, 2012 , Hughes et al, 2018 , Mendiola et al, 2016 , Moran et al, 2017 ), or specific adult subpopulations ( Bazargan et al, 2020 , Crouse Quinn et al, 2017 , Moran et al, 2017 ).…”