New data reveals persistent and stark disparities in seasonal flu vaccine uptake across racial and ethnic groups in the United States, with Asian and white adults consistently demonstrating the highest vaccination rates. Conversely, Black, Hispanic, and American Indian/Alaska Native adults have markedly lower vaccination coverage, a gap that has remained stubborn for over a decade and correlates with higher rates of severe illness and hospitalization from influenza within these communities.
The findings, detailed in reports from the Centers for Disease Control and Prevention, underscore a complex public health challenge rooted in a combination of factors, including unequal access to health care, missed opportunities for vaccination by providers, and a legacy of medical distrust. While overall flu vaccination rates remain below national targets for all groups, the persistent gap highlights systemic issues that leave minority communities more vulnerable to preventable disease year after year. Public health officials continue to emphasize that the influenza vaccine is the most effective tool for preventing infection and reducing the risk of serious complications.
A Decade of Divergent Data
Analysis of national health surveillance data shows a consistent pattern of inequity in vaccination coverage. During the 2021–2022 flu season, for instance, coverage among Asian and white adults was similar, at approximately 54%. In stark contrast, only 42% of Black adults, 41% of American Indian/Alaska Native adults, and just 38% of Hispanic adults received a flu vaccine. This trend has been documented for over a decade, showing little significant progress in closing the gap.
These disparities persist even when controlling for certain access-related factors. According to CDC reports, the differences in vaccination coverage were still present among individuals who had medical insurance, a designated health care provider, and had received a routine medical checkup within the past year. The data is compiled from extensive, long-term national surveys, including the Behavioral Risk Factor Surveillance System (BRFSS) and the Influenza-Associated Hospitalization Surveillance Network (FluSurv-NET), which together provide a comprehensive picture of both vaccination practices and disease burden.
Disparities in Disease Severity
The consequences of lower vaccination rates are severe and measurable, manifesting as higher rates of flu-related hospitalizations among undervaccinated populations. Data collected between 2009 and 2022 reveals that, compared to white adults, hospitalization rates for influenza were nearly 80% higher among Black adults. The rates were also disproportionately high for other groups, with American Indian/Alaska Native adults experiencing hospitalizations at a 30% higher rate and Hispanic adults at a 20% higher rate than their white counterparts.
Pre-existing Conditions as a Factor
Public health experts note that people from some racial and ethnic minority groups experience higher rates of chronic health conditions such as asthma, diabetes, and obesity. These conditions increase the risk of developing serious complications from the flu, making vaccination an even more critical preventive measure. While the flu vaccine may not always prevent infection entirely, it is proven to reduce the severity of the illness, thereby lowering the risk of hospitalization and death. The confluence of higher chronic disease prevalence and lower vaccination coverage creates a compounded risk for these communities.
Structural Barriers to Immunization
A primary driver of vaccination disparities is unequal access to the health care system. Adults from minority groups are more likely to be uninsured and less likely to have a regular source of medical care. CDC analysis shows that adults with insurance, a primary care provider, and a recent medical checkup were significantly more likely to be vaccinated. Hispanic and American Indian/Alaska Native adults, for example, were less likely to report having a primary health care provider or a recent checkup, contributing directly to lower vaccination rates.
Missed Clinical Opportunities
Even when individuals from minority groups do interact with the health care system, opportunities to vaccinate are often missed. Studies show that among adults who had a recent medical appointment during flu season, vaccination coverage remained lower for Black, Hispanic, and American Indian/Alaska Native adults compared to white adults. This indicates that the issue is not solely one of patient access but also involves provider- and system-level failures to offer and administer the vaccine during routine visits. Eliminating these missed opportunities is a key target for public health interventions aimed at improving equity.
The Deep Roots of Vaccine Hesitancy
Beyond structural barriers, lower vaccination rates are also fueled by misinformation and a deep-seated distrust in the medical establishment, often stemming from historical and ongoing experiences with racism and discrimination. Research into the reasons for non-vaccination has found that individuals from some minority communities perceive a higher risk of side effects and have less confidence in the vaccine’s safety and efficacy.
For example, one study found that African Americans were more likely than other groups to cite concerns that the vaccine itself could cause the flu or other serious side effects. Such beliefs are often compounded by a lack of culturally competent health care providers who can effectively address patient concerns and build trust within the community. These attitudinal barriers are a significant, though challenging, aspect of the problem that requires more than just improving physical access to services.
Addressing Inequities in Public Health
Federal agencies and public health organizations are increasingly focused on developing targeted strategies to close the vaccination gap. The CDC has initiated programs designed to partner with community leaders and trusted messengers to promote vaccine confidence and combat misinformation among racial and ethnic minority groups. These initiatives aim to use proven strategies to raise awareness about the seriousness of influenza and break down the specific barriers that prevent people from getting vaccinated.
The long-term goal is to build a more equitable public health infrastructure where preventive services like vaccination are easily accessible to all, regardless of race, ethnicity, or socioeconomic status. This involves not only improving insurance coverage and access to providers but also fostering a health care environment that is trustworthy and responsive to the needs of diverse communities. Improving trust and ensuring equitable access are considered critical components for reducing the disproportionate burden of influenza on vulnerable populations across the country.