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Tufts Public Health » Disparities, Influenza, Older Adults » Influenza and Vaccination Disparities in the U.S.

Influenza and Vaccination Disparities in the U.S.

For the first time in thirteen years, the CDC lists the flu to be ‘widespread’ in all parts of the continental U.S. Since flu season officially began, there have been approximately 60,000 confirmed cases of the flu and the hospitalization rate for influenza has reached 22.7 people/ 100,000 U.S. residents. Here is Massachusetts, reported cases of flu-like illnesses are much higher than last season and are continuing to rise, according to the MA Department of Public Health weekly flu report. The reason for the severity of this flu season comes from this year’s prominent strain being abnormally strong, as well as the persistent problem of low vaccination rates among Americans.

This year, influenza A (specifically H3N2) has been the most rampant flu strain. In past years when H3 strains have been widespread, the U.S. has seen high rates of severe illnesses and lower vaccine effectiveness, such as in the 2012-2013 and 2014-2015 seasons. The CDC also reported that the H3N2 strain was the cause of at least 20 of the 37 reported pediatric deaths this season. Furthermore, vaccination efficacy fluctuates each year and the proportion of recipients protected from the flu can range from as high as 60% to as low as 10%. Studies have shown that even when the anticipated strain is guessed correctly, efficacy of vaccinations can falter. The reason for this is still debated but can be explained by individual immune systems and quirks in the manufacturing of vaccines. Still, with all the doubt surrounding the flu vaccine, all credible scientists and public health officials still recommend that people receive the flu shot—ten percent of the 145 million doses in the 2017-2018 season is still at least 14,500,000 protected people.

That being said, there are still great disparities in vaccination rates among Americans. Vaccination rates among lower income U.S. adults are significantly lower than their wealthier counterparts and in 2015, while those living at or above 400% the Federal Poverty line maintained a vaccination rate of 50.4%, those living below the poverty line had a rate of 33.6%. These lower income Americans also receive less health care due to their income, immigration status, and lower education level. Access to vaccines can be further complicated by linguistic and cultural barriers. According to the CDC’s 2015 report on U.S. health disparities, minority adults (Black, Hispanic) over the age of 17 have had lower rates of influenza vaccination than White Americans since 1999. Minorities also tend to have higher rates of chronic health conditions, making influenza infection-related complications potentially more serious. Combining all these issues, the seasonal flu more severely affects the public health of lower income and uninsured Americans and can lead to greater incidences of death due to influenza.

While childhood vaccination equity has increased in recent years, the lingering disparities of vaccination rates among adults can be addressed on a national level. Initiatives such as the National Influenza Vaccination Disparities Partnership (NIVDP) work in order to alleviate vaccine disparities among these underserved populations. Supported by the CDC, the NIVDP is a collection of local partners who promote the importance of vaccination among low income and minority communities. The CDC also partners with media organization to spread awareness about the importance of the seasonal flu vaccine and provides these organizations with key resources on educating the general public. The CDC has previously released health disparities information regarding vaccines but the frequency of such reports may decrease in the context of CDC budget cuts to initiatives centered on diversity and vulnerability. Despite these cuts, the CDC has still maintained its influenza surveillance system throughout the entire flu season, even during the two-day federal government shutdown. With a growing focus on health equity among public health professionals and academics, we can hope to see a decrease in influenza vaccination disparities in the coming years.

To find out where to get your flu shot, click here.

 

by Donald Clermont, MPH Candidate ’18

Filed under: Disparities, Influenza, Older Adults

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