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										Updated Oct. 18, 2022 | Print1 in 2Only 1 in 2 Americans got a flu vaccine during the 2021–2022 flu season.43%Less than 43% of Black, Hispanic, and American Indian/Alaska Native adults were vaccinated during the 2021–2022 flu season.80%Flu hospitalization rates were nearly 80% higher among Black adults than White adults from 2009–2022.Overview
Flu can be serious and lead to hospitalization or death. Flu vaccination is the best way to protect against flu. Between 140,000 and 710,000 people were hospitalized with flu each year during 2010–2020. People from some racial and ethnic minority groups are more likely to be hospitalized with flu. Compared to White adults, flu hospitalization rates* are:
**Nearly 80% higher** among Black adults
**30% higher** among American Indian/Alaska Native (AI/AN) adults
**20% higher** among Hispanic adultsVaccination may not always prevent infection, but it can make symptoms less severe and reduce the risk of being hospitalized. Since 2010, flu vaccination coverage has been consistently lower among Black, Hispanic, and AI/AN adults. During the 2021–2022 season, flu vaccination coverage was 54% among White adults, 42% among Black adults, 38% among Hispanic adults, and 41% among AI/AN adults. There are many reasons for these inequities, including lack of access to health care and insurance, missed opportunities to vaccinate, and misinformation and distrust. Racism and prejudice are known to worsen inequalities. In addition to disparities in vaccine uptake, there are likely other factors contributing to worse outcomes for some groups.
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 vaccination barriers and raise awareness about the importance of flu vaccination, specifically among people from racial and ethnic minority groups: the Partnering for Vaccine Equity (P4VE) program and a targeted flu vaccination campaign.Read the full *MMWR*ASL video: English | SpanishChallengesshield icon
Lower flu vaccination rates among people from some racial and ethnic minority groups may contribute to disparities such as worse flu outcomes.blue shapeAdvance Equityscales icon
Improve access by partnering with community groups and build vaccine confidence by engaging trusted messengers to promote culturally responsive messages.blue shapeFight Fluhand holding lightbulb icon
Healthcare providers, state and federal governments, and individuals can work together to fight flu.blue shapeChallengesshield icon
Lower flu vaccination rates among people from some racial and ethnic minority groups may contribute to disparities such as worse flu outcomes.blue shapeAdvance Equityscales icon
Improve access by partnering with community groups and build vaccine confidence by engaging trusted messengers to promote culturally responsive messages.blue shapeFight Fluhand holding lightbulb icon
Healthcare providers, state and federal governments, and individuals can work together to fight flu.blue shapeOverview
Flu can be serious and lead to hospitalization or death. Flu vaccination is the best way to protect against flu. Between 140,000 and 710,000 people were hospitalized with flu each year during 2010–2020. People from some racial and ethnic minority groups are more likely to be hospitalized with flu. Compared to White adults, flu hospitalization rates* are:
**Nearly 80% higher** among Black adults
**30% higher** among American Indian/Alaska Native (AI/AN) adults
**20% higher** among Hispanic adultsVaccination may not always prevent infection, but it can make symptoms less severe and reduce the risk of being hospitalized. Since 2010, flu vaccination coverage has been consistently lower among Black, Hispanic, and AI/AN adults. During the 2021–2022 season, flu vaccination coverage was 54% among White adults, 42% among Black adults, 38% among Hispanic adults, and 41% among AI/AN adults. There are many reasons for these inequities, including lack of access to health care and insurance, missed opportunities to vaccinate, and misinformation and distrust. Racism and prejudice are known to worsen inequalities. In addition to disparities in vaccine uptake, there are likely other factors contributing to worse outcomes for some groups.
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 vaccination barriers and raise awareness about the importance of flu vaccination, specifically among people from racial and ethnic minority groups: the Partnering for Vaccine Equity (P4VE) program and a targeted flu vaccination campaign.Read the full *MMWR*ASL video: English | SpanishChallenges
**Access**: People from some racial and ethnic minority groups face barriers to health care in general and, specifically, lack easy access to vaccination. Last flu season, adults with insurance, a healthcare provider, and a medical checkup in the past year were more likely to get a flu vaccine compared with those without. Hispanic adults were less likely to have insurance. Hispanic and AI/AN adults, as well as adults of other races, were less likely to have a healthcare provider and a checkup in the past year. These data suggest lack of healthcare access is contributing to flu vaccination disparities. Further, lack of access to culturally competent providers remains a barrier to vaccination for many people from racial and ethnic minority groups.
**Missed opportunities to vaccinate**: Among adults who reported a recent medical checkup, vaccination coverage was lower among Black, Hispanic, AI/AN, and other/multiple race adults than among White adults. This suggests that healthcare providers are missing opportunities to vaccinate people from some groups during routine medical appointments.
**Mistrust and misinformation**: Misperceptions about how severe flu can be and misinformation about vaccine safety have hurt flu vaccination uptake for years. Systemic racism and historical events have added to a lack of confidence in flu vaccination.Icon of a shieldPeople from Some Racial and Ethnic Minority Groups Are at Higher Risk of Flu Hospitalization
Black, Hispanic, and AI/AN adults were hospitalized with flu at higher rates than White adults during most seasons from 2015 to 2022.
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Infographic: People from Some Racial and Ethnic Minority Groups Are at Higher Risk of Flu HospitalizationPeople from Some Racial and Ethnic Minority Groups Are at Higher Risk of Flu Hospitalization
Black, Hispanic, and AI/AN adults were hospitalized with flu at higher rates than White adults during most seasons from 2015 to 2022.
Rate per 100,000 People
Black
2015–16: 55
2016–17: 101
2017–18: 175
2018–19: 107
2019–20: 130
2021–22: 25
American Indian, Alaska Native
2015–16: 41
2016–17: 66
2017–18: 92
2018–19: 99
2019–20: 104
2021–22: 39
Hispanic
2015–16: 38
2016–17: 59
2017–18: 95
2018–19: 71
2019–20: 78
2021–22: 30
White
2015–16: 28
2016–17: 61
2017–18: 109
2018–19: 63
2019–20: 58
2021–22: 15
The 2020—21 flu season is excluded from this graph because case counts were too low to calculate hospitalization rates by race and ethnicity.
Download Image[PNG]Inequities in Flu Vaccination Coverage Continue
Hispanic, AI/AN, and Black adults received a flu vaccine at lower rates compared to White adults during the 2021–2022 flu season.
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Infographic: Inequities in Flu Vaccination Coverage ContinueInequities in Flu Vaccination Coverage Continue
Hispanic, AI/AN, and Black adults received a flu vaccine at lower rates compared to White adults during the 2021–2022 flu season.
White: 54%
Black: 42%
American Indian, Alaska Native: 41%
Hispanic: 38%
Download Image[PNG]Multiple Actions Work Best to Improve Access and Vaccine Confidence
Using proven measures may help increase flu vaccination among people from racial and ethnic minority communities.
Credits: Philippine Nurses Association of American Foundation (top left), the Ad Council (top right)View Larger
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Infographic: Multiple Actions Work Best to Improve Access and Vaccine ConfidenceMultiple Actions Work Best to Improve Access and Vaccine Confidence
Using proven measures may help increase flu vaccination among people from racial and ethnic minority communities.
Promote community-based vaccination
Use culturally responsive messages
Partner with trusted messengers
Emphasize flu vaccination
Credits: Philippine Nurses Association of American Foundation (top left), The Ad Council (top right)
Download Image[PNG]What Can Be DoneTo Advance Health EquityCOVID-19 vaccination efforts have shown that partnerships with community organizations and trusted messengers can help to increase vaccination rates. The Partnering for Vaccine Equity (P4VE) program aims to reduce disparities in adult vaccination. These partnerships seek to build trust, increase access to vaccination, and combat misinformation. Several promising practices have emerged. Working with community organizations to hold town halls, pop-up clinics, and other outreach activities helps increase trust and access. Partnering with healthcare providers and local media channels can raise awareness of the importance of flu vaccination and address misinformation through accurate information about vaccines.
National vaccination campaigns also can help build confidence in vaccines. Campaigns increase awareness by sharing information about the vaccine(s) and addressing barriers to getting a vaccination. The Ad Council, American Medical Association, and CDC have supported campaigns tailored to reach Black and Hispanic audiences. These campaigns feature culturally responsive content shared through communication channels that are commonly used and trusted. After two years, concerns about flu vaccine risks or side effects decreased from 43% to 33% among Black adults and from 41% to 32% among Hispanic adults. These successes show that tailored messages, when delivered through frequently used and trusted channels, can increase awareness and decrease fears.Photo collage of a woman who got vaccinated, a reminder on a calendar, a vaccine clinic sign, and a man who got vaccinated.COVID-19 vaccination efforts have shown that partnerships with community organizations and trusted messengers can help to increase vaccination rates. The Partnering for Vaccine Equity (P4VE) program aims to reduce disparities in adult vaccination. These partnerships seek to build trust, increase access to vaccination, and combat misinformation. Several promising practices have emerged. Working with community organizations to hold town halls, pop-up clinics, and other outreach activities helps increase trust and access. Partnering with healthcare providers and local media channels can raise awareness of the importance of flu vaccination and address misinformation through accurate information about vaccines.
National vaccination campaigns also can help build confidence in vaccines. Campaigns increase awareness by sharing information about the vaccine(s) and addressing barriers to getting a vaccination. The Ad Council, American Medical Association, and CDC have supported campaigns tailored to reach Black and Hispanic audiences. These campaigns feature culturally responsive content shared through communication channels that are commonly used and trusted. After two years, concerns about flu vaccine risks or side effects decreased from 43% to 33% among Black adults and from 41% to 32% among Hispanic adults. These successes show that tailored messages, when delivered through frequently used and trusted channels, can increase awareness and decrease fears.
Photo collage of a woman who got vaccinated, a reminder on a calendar, a vaccine clinic sign, and a man who got vaccinated.To Fight FluHealthcare providers
Strongly recommend flu vaccination to all patients 6 months and older.
Check vaccination status at all medical visits.
Work with healthcare systems to provide vaccines where people live and work.
Provide culturally appropriate vaccine recommendations, answering all questions from the patient.
Provide a referral if vaccine is not in stock.
Vaccinate all clinic staff and educate them on how to discuss vaccination.State and local governments
Educate community and faith-based organizations on building trust and vaccine confidence within their communities.
Identify barriers to vaccination and work with community organizations to remove those barriers and increase access and convenience.
Host vaccination clinics where people work and play.
Develop influencer-led, culturally responsive community outreach and campaigns with accurate vaccine messages.
Partner with media groups that reach people from racial and ethnic minority communities.
Work with local businesses to make it easy for employees to get vaccinated—for example, host multiple on-site vaccination clinics, open vaccination clinics to employees’ family members, and offer paid time off or financial incentives for employees who get vaccinated.Everyone
**Get vaccinated today**. The best way to protect yourself and your family against severe flu is to get an annual flu vaccine.
Encourage others to get a flu vaccine and share facts about flu vaccines with your community.Healthcare providers
Strongly recommend flu vaccination to all patients 6 months and older.
Check vaccination status at all medical visits.
Work with healthcare systems to provide vaccines where people live and work.
Provide culturally appropriate vaccine recommendations, answering all questions from the patient.
Provide a referral if vaccine is not in stock.
Vaccinate all clinic staff and educate them on how to discuss vaccination.State and local governments
Educate community and faith-based organizations on building trust and vaccine confidence within their communities.
Identify barriers to vaccination and work with community organizations to remove those barriers and increase access and convenience.
Host vaccination clinics where people work and play.
Develop influencer-led, culturally responsive community outreach and campaigns with accurate vaccine messages.
Partner with media groups that reach people from racial and ethnic minority communities.
Work with local businesses to make it easy for employees to get vaccinated—for example, host multiple on-site vaccination clinics, open vaccination clinics to employees’ family members, and offer paid time off or financial incentives for employees who get vaccinated.Everyone
**Get vaccinated today**. The best way to protect yourself and your family against severe flu is to get an annual flu vaccine.
Encourage others to get a flu vaccine and share facts about flu vaccines with your community.Footnotes and References
	Footnote
*Hospitalization rate ratios compare the rate for adults from each racial/ethnic minority group to the rate for non-Hispanic White adults and can also be represented as percentages. In *MMWR*(from 2009–2022, excluding the 2020–2021 season), 80% higher is indicated as 1.8 times higher, 30% higher is indicated as 1.3 times higher, and 20% higher is indicated as 1.2 times higher.
References
Nowak GJ, Sheedy K, Bursey K, Smith TM, Basket M (2015). Promoting influenza vaccination: insights from a qualitative meta-analysis of 14 years of influenza-related communications research by U.S. Centers for Disease Control and Prevention (CDC). *Vaccine*, 33(24), 2741–2756. https://doi.org/10.1016/j.vaccine.2015.04.064.
Centers for Disease Control and Prevention. (2022, July 1). What is Health Equity? | Health Equity | CDC.Related Pages and Resources
*Vital Signs:* Media Statement – Inequities Found in Flu Vaccine Uptake [English]
*Vital Signs:* Media Statement – Hallan inequidades en el uso de la vacuna contra la influenza (gripe) [Spanish]
*Morbidity and Mortality Weekly Report (MMWR): *Vital Signs*:*Influenza Hospitalizations and Vaccination Coverage by Race and Ethnicity—United States, 2009–10 Through 2021–22 Influenza Seasons
Science Clips
Equity in Adult Vaccination
GetMyFluShot.org
Flu Disparities Among Racial and Ethnic Minority Groups
Weekly Flu Vaccination Dashboardemail_03Vital Signs Update	Get email updates about Vital Signs		Email Address			What's this?				Submit**VITAL SIGNS RESOURCES**
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			Last Updated Oct. 18, 2022														Source: 	Office of the Associate Director for Communication
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