Racial and Ethnic Disparities in Influenza Vaccination among Adults with Chronic Medical Conditions Vary by Age in the United States

Abstract

BackgroundPeople living with chronic health conditions exhibit higher risk for developing severe complications from influenza according to the Centers for Diseases Control and Prevention. Although racial and ethnic disparities in influenza vaccination have been documented, it has not been comprehensively determined whether similar disparities are present among the adult population with at least one such condition.ObjectiveTo study if racial and ethnic disparities in relation to influenza vaccination are present in adults suffering from at least one chronic condition and if such inequalities differ between age groups.MethodsThe Medical Expenditure Panel Survey (2011–2012) was used to study the adult population (age ≥18) who had at least one chronic health condition. Baseline differences in population traits across racial and ethnic groups were identified using a chi-square test. This was conducted among various age groups. In addition, survey logistic regression was utilized to produce odds ratios of receiving influenza vaccination annually between racial and ethnic groups.ResultsThe total sample consisted of 15,499 adults living with at least one chronic health condition. The numbers of non-Hispanic whites (whites), non-Hispanic blacks (blacks), and Hispanics were 8,658, 3,585, and 3,256, respectively. Whites (59.93%) were found to have a higher likelihood of self-reporting their receipt of the influenza vaccine in comparison to the black (48.54%) and Hispanic (48.65%) groups (P<0.001). When examining persons aged 50–64 years and ≥65 years, it was noted that the black (54.99%, 62.72%) and Hispanic (53.54%, 64.48%) population had lower rates of influenza vaccine coverage than the white population (59.22%, 77.89) (both P<0.0001). No significant differences between whites and the blacks or Hispanics were found among the groups among adults between 18 and 49 inclusive (P>0.05). After controlling for patient characteristics, the difference in influenza vaccine coverage between whites and the minority groups were no longer significant for adults aged 50–64 years. However, the difference were still statistically significant for those aged ≥65 years.ConclusionsIn the United States, there are significant disparities in influenza vaccination by race and ethnicity for adults over 65 years with at least one chronic health condition. Future research is needed to help develop more targeted interventions to address these issues and improve influenza vaccination rates.

Understanding and Increasing Influenza Vaccination Acceptance: Insights from a 2016 National Survey of U.S. Adults

“…Overall, surveys of U.S. adults, while primarily focused on 2009 H1N1 vaccination, have also found healthcare provider recommendations, susceptibility and severity perceptions, and past experience with influenza illness and vaccination correlated with seasonal influenza vaccination [ 13 , 14 , 15 , 16 , 17 ]. Racial and ethnic differences also have been frequently documented [ 18 , 19 , 20 ], with the 2015–2016 seasonal vaccination rates ranging from 44.5% for non-Hispanic Whites to 36.6% for non-Hispanic Blacks to 34.4% for Hispanics [ 4 ].…”

Influenza Vaccination among Underserved African-American Older Adults

“…One striking finding of our study is the lack of association between self-report of current flu vaccination and being diagnosed with a major chronic condition such as CVD, COPD, diabetes, stroke, and cancer. It has been previously shown that older African-Americans with chronic conditions have lower rates of flu vaccination [ 7 , 31 ]. A systematic review and meta-analysis of six decades of randomized clinical trials that compared flu vaccine versus placebo among individuals at high risk for CVD showed that the flu vaccine lowered the risk of major adverse cardiovascular events [ 32 ].…”

Disparities in Temporal and Geographic Patterns of Myocardial Infarction Hospitalization Risks in Florida

“…Cultural attitudes towards seeking health care, lower literacy levels, higher unemployment rates, inadequate social support, and higher levels of chronic stress in rural areas may also increase risk of CVD [65,84] and attenuate the effects of efforts to improve cardiovascular health [85,86]. Variations in exposures such as extreme cold or hot temperature, air pollution, and influenza vaccination, may also have contributed to the disparities in MI hospitalization risks [87,88,89].…”