Only 1 in 3 US adults got flu shot in 2018, study may inform public health efforts for future Covid-19 vaccine
Just one in three adults in the US received the flu vaccine in 2018, a number that has significant implications for the impending flu season, according to researchers. It threatens to overwhelm health resources and lead to deaths at a time when Americans are still reeling from the Covid-19 pandemic, argues the team from the University of California San Francisco (UCSF), who led the study. The analysis reveals that vaccination rates were lower among Blacks and Hispanics (33.9% and 28.9%) than Whites and Asians (41.5% and 38.3%). Men were less likely than women to receive the flu shots (36.7% versus 41.6%).
The authors found that age, insurance status and having a personal doctor were among the biggest determinants of whether a given individual had a flu shot. The findings show that 22.6% of those in the 18 to 24 age group got the flu vaccine, versus 59.3% of those over 75. Among those without insurance, 16.1% were vaccinated as compared to 41.6% for those with insurance. For patients without a personal doctor, 19.4% were vaccinated versus 43.6% for those with a personal doctor. Not having a chronic condition was also associated with lower rates of vaccination. An estimated 31.6% of those with no chronic condition were vaccinated, versus 52.7% for people with four or more chronic conditions. Variation by income group was smaller. About 33.9% for those with a household income of less than $15,000 were vaccinated, compared to 41.8% of those with an income of more than $50,000, says the study published in the Journal of General Internal Medicine.
The findings shed light on groups most likely to skip shots, and may inform public health efforts for future Covid-19 vaccines, emphasizes the team. “To achieve herd immunity, we would need to reach about an 80% vaccination rate, but no subgroup in our study exceeded 60%. While social distancing, mask-wearing and staying away from crowds will mitigate the spread of the flu, a dangerous type of the flu, such as the Spanish flu of 1918, could result in more than 61,000 fatalities,” explains senior author Dr R Adams Dudley, referring to the 2017-18 flu season. Dudley is from the UCSF Philip R Lee Institute for Health Policy Studies and School of Medicine, and University of Minnesota Medical School and Institute for Health Informatics.
The researchers evaluated self-reported flu vaccination rates for 2018, which included data from the 2017-18 flu season (61,000 deaths) and 2018-19 season (34,200 deaths). The data was recorded in the Behavioral Risk Factor Surveillance System, an annual national survey of 400,000-plus US adults, conducted by state health departments and the Centers for Disease Control and Prevention (CDC). The results show that vaccination rates were lowest in Texas (26.4%) and highest in Washington DC (44.2%). Other states with low rates were Louisiana (26.4%), New York (28%), Indiana (28.5%) and Tennessee (28.6%). Other states with high rates were West Virginia (42.6%), North Carolina (41.7%), Iowa (40.6%) and Pennsylvania (40.3%). In California, 32.4% were vaccinated.
According to the investigators, to boost vaccination rates, both long-term and short-term interventions are needed. “We need a concerted public health campaign that includes public health officials, health care providers, and local communities, and reaches those groups most at risk for not getting vaccinated. We need a proactive primary care outreach strategy to address patient concerns and provide information on how and where to get vaccinated,” suggests first author Brandon Yan, a third-year medical student at UCSF.
In the long-term, the goals could include making the vaccines more accessible, such as expanding availability in grocery store pharmacies and making them free of charge for those who are uninsured, says the analysis. “The ongoing pandemic also raises the issue of whether the flu vaccine and the future Covid-19 vaccine should be mandated. While a federal mandate may be difficult politically, private organizations like colleges and employers could make attendance and employment contingent on getting up-to-date with vaccines,” recommends Yan.