How Vaccine-Seeking Factors Into Disparities In Adult Influenza Vaccination

Background:  Racial/ethnic disparities in influenza vaccine uptake among adults are longstanding and research suggests they result from multiple factors. Previous studies suggest that influenza vaccine-seeking behavior may be an important aspect to consider when evaluating disparities in vaccination coverage.

Objectives:  To determine if there are differences, by race or ethnicity, in influenza vaccination-seeking behavior among adults 65+ years of age.

Methods:  We analyzed data from a national sample of 3138 adults age 65 and older collected through the adult module of the 2007 National Immunization Survey, a random digit dialing telephone survey.  We examined influenza vaccination rate, location of vaccination, and whether those who were vaccinated specifically went to the location to receive the influenza vaccine (vaccine seekers) by race/ethnicity.  We also examined the relationship between attitudes about influenza vaccination and vaccine seeking behavior by race/ethnicity. 

Results:  White (W) and Hispanic (H) adults ≥65 years were significantly more likely to receive influenza vaccine than African Americans (AA), during the 2006-2007 influenza season  (68%±2, 66%±4, and 54%±2, respectively), and overall a significantly higher proportion of  W and H reported seeking out the vaccine (“vaccine seekers”) than AA (44%±3, 41%±5, 25%±2, respectively).  AA were less likely to be vaccine seekers, regardless of education or poverty levels.  Among persons vaccinated in a doctor’s office, 51% of W/H specifically went there to get vaccinated, compared to 37% of AA. Among persons who believe the vaccine is very effective, 55%±4 of W and 54%±6 of H vs. 39%±4 of AA were vaccine seekers.  

Conclusions:  This analysis of vaccine seeking by race/ethnicity suggests that lower vaccination rates among AA may be related to a lower likelihood of seeking out vaccine. Many interventions focus on ensuring that providers consistently offer vaccine, but concurrent efforts to increase vaccine seeking among  AA are  needed  to reduce disparities.