Influenza Vaccine Rates Increased Among Black, Hispanic Older Adults

Hispanic and Black adults aged 65 or older exhibited increased influenza vaccine rates during the COVID-19 pandemic (2019-2022), according to a study published in JAMA Network Open.¹ White adults of the same age living in rural areas and having low educational attainment saw decreased flu vaccine rates during the same time period.

“Although influenza vaccination rates have slowly increased over the past 10 years and are highest among older adults, vaccination remains underused, particularly for American Indian or Alaska Native, Black, and Hispanic adults,” wrote authors of the study. “When considering all adults, influenza vaccination during the 2021-2022 season was lower among Hispanic (37.9%), American Indian or Alaska Native (40.9%), and Black (42.0%) adults than among White (53.9%) and Asian American (54.2%) adults; this pattern continued through the 2022-2023 season and has been consistently observed since the 2010-2011 season.”

Vaccine disparities among race have been historically notable across the health care sector. Going back to the COVID-19 pandemic and the years that followed, CDC statistics for the 2021-2022 flu season show that approximately half of all US patients received a flu vaccine yet only 43% of Black, Hispanic, and American Indian/Alaska Native adults received one.²

Among all the historical data, researchers wanted to further progress their knowledge of influenza vaccination rates throughout the pandemic. | image credit: fotodrobik / stock.adobe.com

READ MORE: FDA Approves COVID-19 Vaccines for Patients 65 Years and Older

While a variety of personal challenges can impact any patients’ ability to get vaccinated, there are often 3 key issues that perpetuate racial disparities between White patients and those of other races when it comes to vaccination. Those issues include access, missed vaccination opportunities, and mistrust or misinformation.

Because minority groups like Black and Hispanic patients are often impacted by financial and socioeconomic inequities, their access to essential vaccines is often hindered. There have also been reports of missed opportunities to vaccinate Black and Hispanic patients who even had insurance and regularly checked in with their medical providers. Despite many patients in minority groups reporting these regular visits, their vaccination rates were still significantly lower compared with White patients.^1,2

Finally, the CDC mentions misinformation—a phenomenon that skyrocketed in notoriety during the pandemic. While misinformation and distrust during the pandemic were not exclusive to specific groups of patients, minority groups have historically been led to distrust medical information because of events like the Tuskegee Syphilis Study—which was a massive mistreatment of research study subjects that were mostly Black.³

Among all the historical data and more recent exploration of trends during the pandemic, researchers wanted to further progress their knowledge of influenza vaccination rates throughout this time and how older adults specifically felt toward the vaccine during an unprecedented medical emergency.

“In this study, we use national data from the Medicare Consumer Assessment of Healthcare Providers and Systems (MCAHPS) survey to examine patterns of influenza vaccination among older adults in the US before vs late in the COVID-19 pandemic,” continued the authors.¹ “The larger sample size and richer data allow for the investigation of national patterns by race and ethnicity, educational attainment, and rurality.”

Serving as a more encapsulating approach to flu vaccine data during the pandemic, researchers hoped to provide a larger scope of these trends and understand them specifically among older adults of varying social lifestyles. They conducted a retrospective study of MCAHPS survey respondents from 2019 and 2022. Participants had to be Medicare Advantage or Medicare fee-for-service enrollees aged 65 years or older living in the 50 US states or Washington, DC.

A total of 285,265 survey responses (54.5% women; 76.2% White) were included in the study. Overall, influenza vaccination rates increased modestly, by 0.7%, throughout the 4-year period. However, while rates among White, Asian American, Native Hawaiian, and Other Pacific Islander adults went relatively unchanged, older Black (3.8%) and Hispanic (2.3%) adults experienced increases in flu vaccination.

“Rural Black and Hispanic older adults had the largest estimated increases during this period, at 7 percentage points for Black older adults and 8.2 percentage points for Hispanic older adults, while White older adults with lower educational attainment and/or living in rural areas had the largest estimated decreases in influenza vaccination rates at approximately 2 percentage points,” they wrote.¹ “These findings are encouraging for populations that have been historically more difficult to reach with interventions.”

The researchers do not have concrete evidence as to why some races overcame others during the pandemic in regard to flu vaccine rates. However, they believe that the pandemic itself had spillover effects, with heightened efforts to increase COVID-19 vaccine rates translating to higher rates of the flu vaccine. And while all races were encouraged to receive the COVID-19 vaccine, the increased efforts in underserved populations may correlate with increased rates among Black and Hispanic older adults.

With significant uncertainty, however, among why these rates differed by race, future research into this data pool during the pandemic is warranted.

“Although overall influenza vaccination rates did not change substantially from 2019 to 2022, there were substantial increases for Black and Hispanic older adult populations with historically low vaccination, while White older adults with lower educational attainment and/or living in rural areas had decreased rates of vaccination,” they concluded.¹ “Determining the reasons for these divergent changes is a high priority for future studies.”

READ MORE: Immunization Resource Center

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Reference

1. Gidengil C, Haviland A, Hambarsoomian K, et al. Influenza vaccination among people with Medicare by race and ethnicity, education, and rurality. JAMA Netw Open. 2025;8(4):e254462. doi:10.1001/jamanetworkopen.2025.4462

2. Inequities in flu vaccine uptake. CDC. October 18, 2022. Accessed August 29, 2025. https://www.cdc.gov/vitalsigns/flu-inequities/index.html

3. About the untreated syphilis study at Tuskegee. CDC. September 4, 2024. Accessed August 29, 2025. https://www.cdc.gov/tuskegee/about/index.html