Flu Season 2020: People of color in US are more likely to be hospitalized but less likely to get vaccinated
Racial and ethnic minority groups in the US are more heavily impacted by the flu. They may be at a higher risk of getting the flu or developing serious illness, resulting in hospitalization. This includes non-Hispanic Black, non-Hispanic American Indian or Alaska Native, and Hispanic or Latino people. Non-Hispanic Black persons have the highest flu-related hospitalization rates (68 per 100,000) compared to other racial/ethnic groups, according to the analysis of flu hospitalization rates by race and ethnicity during 10 flu seasons — from 2009-2010 through 2018-2019 — by the US Centers for Disease Control and Prevention (CDC).
The next in line are non-Hispanic American Indian or Alaska Native persons, who have the second-highest flu-related hospitalization rates, which is 48 per 100,000. Hispanic or Latino persons have the third-highest flu-related hospitalization rates (44 per 100,000). “Non-Hispanic White persons had lower flu-related hospitalization rates (38 per 100,000) compared to these three groups. Non-Hispanic Asian persons had the lowest flu-related hospitalization rates (32 per 100,000)," reveals the analysis. "Because people of color may be at higher risk for getting flu or developing serious illness, resulting in hospitalization, flu vaccination is especially important for these communities," suggests the CDC.
Previous reports have also highlighted similar disparities. A 2016 study, for example, shows that during the 2010-11 and 2011-12 flu seasons, non-Hispanic Black persons across age groups, and Hispanic or Latino persons, five years and older, were more likely to be hospitalized with flu than non-Hispanic White people. People who lived in high poverty census tracts also represented a demographic group at higher risk for severe influenza outcomes, indicating that socioeconomic status may be a factor contributing to higher flu-related hospitalization rates among these groups.
According to another analysis done in 2011, Hispanic or Latino persons were more likely than non-Hispanic White persons to be exposed to flu viruses, because of the jobs they often have, which means interacting a lot with the public or because of crowded living conditions, often living with extended family.
Racial/ethnic disparities in flu vaccination coverage persist
To reduce the risk of influenza illness, hospitalization and death, the CDC recommends routine annual flu vaccination for all people, 6 months and older. According to a recent analysis, flu vaccination coverage has increased for both children and adults over the past two flu seasons. However, racial and ethnic disparities in flu vaccination coverage continue to persist. Among all Americans 6 months and older, the percentage vaccinated during the 2019-20 season was 51.8%, 2.6 percentage points higher than coverage in the 2018-19 season. However, while coverage during the 2019-20 season increased for White people and people of other non-Hispanic race, it did not increase for Black or Hispanic people. "White people had higher flu coverage than black, Hispanic, and other people. Additionally, people of non-Hispanic other races had higher coverage than black and Hispanic people," the authors write.
Among adults aged 18 years and older, the overall coverage estimate was 48.4% during the 2019-2020 flu season, 3.1 percentage points higher than coverage during the 2018-19 season. But Hispanic adults and non-Hispanic Black adults had lower flu vaccination coverage than non-Hispanic White adults. Flu vaccination coverage was 38% among Hispanic or Latino persons followed by 41% among non-Hispanic Black persons, 42% among American Indian or Alaska Native persons, and 52% among Asian persons. It was highest among non-Hispanic White Americans at 53%.
"Flu vaccination coverage for Hispanic adults and non-Hispanic Black adults during the 2019-20 season did not show statistically significant changes compared with the 2018-19 season, while non-Hispanic White adults and other race/ethnicity adults had increases in coverage. Similar to the 2018-19 season, differences in flu vaccination coverage were observed between racial/ethnic groups. Non-Hispanic White adults had higher flu coverage than non-Hispanic Black, Hispanic, and adults of other racial/ethnic groups. Additionally, Hispanic and non-Hispanic Black adults had lower flu vaccination coverage than adults of other racial/ethnic groups. Lastly, Hispanic adults also had lower coverage than non-Hispanic Black adults,” the findings state.
Among children (6 months to 17 years), flu vaccination coverage for Hispanic children and non-Hispanic Black children during the 2019-20 season did not show statistically significant changes compared with the 2018–19 season, while non-Hispanic White children and children in the non-Hispanic other race/ethnicity group had increases in coverage. Non-Hispanic Black children had lower flu vaccination coverage than children in all other racial/ethnic groups.
"Vaccinating people at high risk is especially important to decrease their risk of severe flu illness. Many people at higher risk from flu complications also are at higher risk from Covid-19. Getting a flu vaccine will not protect against Covid-19, but flu vaccination has many other important benefits. Flu vaccines have been shown to reduce the risk of flu illness, hospitalization, and death,” explain the authors.
Health experts emphasize that getting a flu vaccine is more important than ever this fall and winter because flu and Covid-19 may both be spreading in the US at the same time. “A flu vaccination not only reduces a person’s risk from flu but may also help conserve potentially scarce healthcare resources. During the Covid-19 pandemic, reducing the overall burden of respiratory illnesses is important to protect vulnerable populations at risk for severe illness, the healthcare system, and other critical infrastructure. Thus, healthcare providers should use every opportunity during the flu vaccination season to administer flu vaccines to all eligible persons,” the CDC recommends.
To increase flu vaccination, the agency says that it is engaging with partners and developing customized outreach to racial and ethnic minority communities, including developing culturally specific messaging and linguistically tailored content to reach additional audiences. Providing additional funding to state immunization programs to plan and implement flu vaccination programs for the 2020-2021 flu season, with a focus on priority groups, including non-Hispanic Black and Hispanic or Latino populations, is also being undertaken.