Health Equity and Flu

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Influenza (flu) can be serious and can lead to hospitalization and death; however, certain groups of people, including certain racial and ethnic minorities experience an unequal burden of severe flu outcomes. Long standing social and health inequities likely contribute to this.

More Serious Flu Outcomes

Black, Hispanic, and American Indian and Alaska Native (AI/AN) people often have had higher rates of hospitalization across all ages, from 2009 to 2023, after adjusting for age.

Compared to White adults, age-adjusted flu hospitalization rates were:

  • 1.8 times higher among Black adults
  • 1.4 times higher among American Indian or Alaska Native adults
  • 1.2 times higher among Hispanic or Latino adults

Compared with White children (0 to 17 years), age-adjusted flu hospitalization rates were:

  • 2.5 times higher among American Indian/Alaska Native children
  • 2.2 times higher among Black children
  • 1.7 times higher among Hispanic or Latino children

*In all influenza seasons except 2021-22, rates reflect cases hospitalized during October 1 – April 30 of each influenza season. In 2021-22, rates reflect cases hospitalized beginning October 1, 2021, but given late influenza season activity, the season was extended to June 11, 2022. Additionally, during the 2020-21 season, case counts were not sufficient to allow reporting of stratified cumulative rates or weekly rates.

*In all influenza seasons except 2021-22, rates reflect cases hospitalized during October 1 – April 30 of each influenza season. In 2021-22, rates reflect cases hospitalized beginning October 1, 2021, but given late influenza season activity, the season was extended to June 11, 2022. Additionally, during the 2020-21 season, case counts were not sufficient to allow reporting of stratified cumulative rates or weekly rates.

Additional information and data is available on FluView Interactive.

Flu Vaccination is the Best Protection. Other Preventive Actions Can Also Help.

A flu vaccine is the best way to protect against flu and its potentially serious complications. In addition to reducing risk of flu illness, flu vaccination has been shown in several studies to reduce severity of illness in people who get vaccinated but still get sick with flu. That means vaccinated people could be less likely to be hospitalized with flu or less likely to be admitted to the ICU with flu. More information is available at What are the benefits of flu vaccination?. CDC recommends that everyone 6 months and older get a seasonal flu vaccine each year, ideally by the end of October.  In addition to getting a flu vaccine, everyone should take everyday preventive actions, including avoiding people who are sick, covering coughs, and washing hands often.

Inequities in Vaccination Persist

Since 2010, flu vaccination coverage has been consistently lower among Black, Hispanic, and AI/AN adults. During the 2022–2023 season, flu vaccination coverage was:

  • 51% among White adults
  • 51% among Asian adults
  • 43% among Black adults
  • 37% among AI/AN adults and
  • 37% among Hispanic adults

During the 2022–2023 season, among children (6 months–17 years), flu vaccination coverage was:

  • 72% among Asian children
  • 56% among White children
  • 61% among Hispanic or Latino children
  • 53% among Black children and
  • 51% among AI/AN children

Causes of Disparities

There are likely several factors contributing to disparities in flu vaccination, many of which are rooted in health and societal inequities. These include but are not limited to:

  • lack of access to health care and insurance,
  • higher prevalence of underlying medical conditions,
  • missed opportunities to vaccinate (healthcare providers may be missing opportunities to vaccinate people during routine medical appointments),
  • misinformation about vaccination, and
  • distrust of medical institutions.

In addition to disparities in vaccine uptake, there are likely other factors contributing to worse outcomes for some groups. Racism and prejudice are also known to worsen inequalities. Identifying and responding to these inequities is important for reducing health disparities.

Learn more about factors that can impact health outcomes at: What is Health Equity?

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CDC’s Commitment to Health Equity and Reducing Disparities

Increasing equitable vaccine uptake requires addressing the range of reasons why people do not get vaccinated. Over the past two years, CDC has begun two programs to address barriers to and raise awareness about the importance of flu vaccination, specifically among people from racial and ethnic minority groups. These include the Partnering for Vaccine Equity (P4VE) program and a targeted flu vaccination campaign. Using proven measures may help increase vaccination among people from racial and ethnic minority communities.

For more information about what CDC is doing to address inequities in flu vaccine uptake and what healthcare providers, state and local governments, and individuals can do, visit CDC Flu Vital Signs .

CDC is also continuing to collect data to better understand how racial and ethnic minorities are disproportionately impacted by flu-related hospitalization.