Older Women, African Americans Less Likely to Get Flu Vaccines

Older women and African Americans are less likely than any other demographics to get vaccinated against the flu, viewing potential side effects of the vaccine as a greater risk than catching the flu itself. This is according to a study recently published in Risk Analysis: An International Journal.

The study authors found that not only are African Americans less likely to get vaccinated against the flu in the first place, but they also tend to have “greater regret of side effects” than white individuals who get the vaccine.

“It’s a common assumption in all risk perception research that demographic differences contribute to differential perception of risk,” observed Vicki Freimuth, PhD, the lead author on the study and a professor of health and risk communications at the University of Georgia, in her initial observations on the research questions addressed in the study. She added, “The majority of US risk research in health is not designed to assess racial differences, but rather includes race as one of many demographic variables.” In this study, the group sought to confirm their suspicions that “risk operates differently across [nonwhite identity] populations.” In addition, although the focus of the study was race, the research team also examined gender and age biases against the flu vaccine.

After analyzing 838 white and 819 African American study participants, following the peak of the 2015 flu season, the research team found that 41% of African-Americans surveyed had received the vaccine compared with 47% of white patients. “We conducted 16 cognitive interviews… with whites and African Americans, to test and clarify items [on the survey questions],” Dr. Freimuth recounted in the article, adding that the biggest difference between the two races quickly became apparent: while more than half of both races essentially considered catching the flu “no big deal,” patients who were African American “focused on potential side effects and low confidence in the flu vaccine.” This tendency led the group to evaluate vaccine risk, disease risk, and the emotions of worry and regret.

To this end, the research team discovered that significant subpopulations of both groups had concerns about the flu vaccine and ultimately opted not to get vaccinated, but that they did so along different sociodemographic lines. “For perception of disease risk for the white group, gender, age, and income were significantly related,” said Dr. Freimuth. On the other hand, she added, “only gender and age were significantly related to disease risk for African Americans.” In both races, women were more concerned about the risks associated with getting the flu than the risks associated with getting the vaccine, and that concern increased with age as well. Within the female subgroup, “the higher the age and education level, the lower the perceived risk of the vaccine” as well, said Dr. Freimuth.

When it came to regretting getting vaccinated, white study participants and African-American study participants differed as well. Participants were asked to rate their level of regret based on two questions: how much they thought they would regret getting the flu vaccine, and how much they would regret getting the flu. The rating scale was between on and four, with one being “no regret” and four being a “great deal” of regret. The results ultimately indicated that African Americans would regret getting the shot more than white respondents if they experienced side effects.

Dr. Freimuth noted that the implications of the study are limited because “the only context examined was the seasonal flu vaccination.” She added, “The sample was adults who were making a decision about the seasonal vaccine for themselves. If these adults were making a decision for their children or the decision was about an emergency vaccine rather than a routine one, the results might be quite different.”

To this end, the group speculated that fewer than half of all respondents got the vaccination possibly because “flu vaccination is routine and may not stimulate the kind of emotional reactions that an emergency does.” However, Dr. Freimuth added that there is likely an element of mistrust involved in the decision as well. “The trust of the American people in the government is at an all-time low, which also feeds into fear of vaccines,” she said in a public statement on the research. “Perhaps increasing knowledge about the process… may decrease perception of risk from the vaccine.”