Racial disparities in vaccination for seasonal influenza in early childhood

Public Health. 2018 May;158:1-8. doi: 10.1016/j.puhe.2018.01.030. Epub 2018 Mar 7.


Objectives: Influenza vaccination is the best protection against infection and severe complications of disease, such as hospitalization and death. Therefore, it is important to accurately estimate vaccination coverage and to evaluate the role of race/ethnicity. This study examines racial disparities in influenza vaccination among children using a nationally representative sample.

Study design: This study used cross-sectional data from the 2009-2014 National Immunization Survey for children aged 19-35 months (n = 98,186) in the United States.

Methods: The outcome variable was receipt of influenza vaccination (yes/no) and exposure variable was race/ethnicity. Weighted multivariate logistic regression was used to estimate the odds ratio and 95% confidence intervals (CIs) for the effect of race/ethnicity on receipt of the influenza vaccine.

Results: The overall vaccination rates were 81.6% for non-Hispanic whites, 79.2% for Hispanics, 80.5% for non-Hispanic blacks, and 80.7% for non-Hispanic mixed/other. In the adjusted model, compared with non-Hispanic white children, Hispanic children were 13% less likely to receive influenza vaccination within the last 12 months (adjusted odds ratio [aOR] = 0.87; 95% CI: 0.80-0.94). In addition, children aged 24-29 months (aOR = 0.48; 95% CI: 0.44-0.52) and 30-35 months (aOR = 0.33; 95% CI: 0.30-0.36) were significantly less likely to receive influenza vaccination within the last 12 months compared with those who were 19-23 months old.

Conclusions: There were differences in influenza vaccination rates among different racial groups. Hispanic children had the lowest vaccination rates. Findings from our study have significant implications for targeted interventions to increase the overall vaccination rate for children in the United States.

Keywords: Children; Influenza; National Immunization Survey; Racial disparities; Vaccination.

MeSH terms

  • African Americans / statistics & numerical data
  • Child, Preschool
  • Continental Population Groups / statistics & numerical data*
  • Cross-Sectional Studies
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Healthcare Disparities / ethnology*
  • Hispanic Americans / statistics & numerical data
  • Humans
  • Infant
  • Influenza Vaccines / administration & dosage*
  • Influenza, Human / prevention & control*
  • Male
  • Seasons
  • United States
  • Vaccination / statistics & numerical data*


  • Influenza Vaccines