Can routine offering of influenza vaccination in office-based settings reduce racial and ethnic disparities in adult influenza vaccination?

J Gen Intern Med. 2014 Dec;29(12):1624-30. doi: 10.1007/s11606-014-2965-z. Epub 2014 Aug 26.


Background: Influenza vaccination remains below the federally targeted levels outlined in Healthy People 2020. Compared to non-Hispanic whites, racial and ethnic minorities are less likely to be vaccinated for influenza, despite being at increased risk for influenza-related complications and death. Also, vaccinated minorities are more likely to receive influenza vaccinations in office-based settings and less likely to use non-medical vaccination locations compared to non-Hispanic white vaccine users.

Objective: To assess the number of "missed opportunities" for influenza vaccination in office-based settings by race and ethnicity and the magnitude of potential vaccine uptake and reductions in racial and ethnic disparities in influenza vaccination if these "missed opportunities" were eliminated.

Design: National cross-sectional Internet survey administered between March 4 and March 14, 2010 in the United States.

Participants: Non-Hispanic black, Hispanic and non-Hispanic white adults living in the United States (N = 3,418).

Main measures: We collected data on influenza vaccination, frequency and timing of healthcare visits, and self-reported compliance with a potential provider recommendation for vaccination during the 2009-2010 influenza season. "Missed opportunities" for seasonal influenza vaccination in office-based settings were defined as the number of unvaccinated respondents who reported at least one healthcare visit in the Fall and Winter of 2009-2010 and indicated their willingness to get vaccinated if a healthcare provider strongly recommended it. "Potential vaccine uptake" was defined as the sum of actual vaccine uptake and "missed opportunities."

Key results: The frequency of "missed opportunities" for influenza vaccination in office-based settings was significantly higher among racial and ethnic minorities than non-Hispanic whites. Eliminating these "missed opportunities" could have cut racial and ethnic disparities in influenza vaccination by roughly one half.

Conclusions: Improved office-based practices regarding influenza vaccination could significantly impact Healthy People 2020 goals by increasing influenza vaccine uptake and reducing corresponding racial and ethnic disparities.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Black or African American / statistics & numerical data
  • Cross-Sectional Studies
  • Female
  • Healthcare Disparities / ethnology*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Influenza Vaccines / administration & dosage*
  • Influenza, Human / prevention & control*
  • Male
  • Middle Aged
  • Office Visits / statistics & numerical data*
  • Seasons
  • United States
  • Vaccination / statistics & numerical data
  • White People / statistics & numerical data
  • Young Adult


  • Influenza Vaccines