How Flu Vaccination Uptake Affects COVID-19 Vaccine Distribution

November 12, 2020 - States must address variations in flu vaccination uptake to ensure successful COVID-19 vaccine distribution, a new Kaiser Family Foundation (KFF) report indicates. 

KFF obtained data from the CDC’s 2019 to2020 Influenza Season Vaccination Coverage Dashboard and focused on the differences in flu vaccine uptake by states, age, race/ethnicity, and health risk status.

In an overall state variation analysis, researchers found that 52 percent of the US population six months and older received the seasonal flu vaccine last season. 

Rates for flu vaccination were the highest in the Northeast (57 percent), followed by the Midwest (54 percent), the South (52 percent), and the West (51 percent).

But in 12 states, less than half of the population received a flu vaccine. 

Overall, the national annual flu vaccination percentage was well below the Healthy People 2030 target of 70 percent for all racial groups. 

Additionally, Black and Hispanic people were even less likely to have received the flu vaccination compared to their White counterparts (46 percent and 47 percent, respectively, compared to 55 percent).

Notably, no state achieved the target vaccination level for Black or Hispanic people. 

Researchers also observed significant variation in flu vaccine uptake among age groups and health risk status.

Across all race/ethnic groups, adults with comorbidities were more likely to be vaccinated for the flu compared to those without such conditions. 

Similar to older adults, individuals under 65 with underlying medical conditions are at a heightened risk of severe illness from COVID-19. Therefore, they are a priority group for vaccine rollout. 

Overall, in the 2019 to 2020 season, non-elderly adults with underlying health conditions were more likely to receive a flu vaccine (51 percent) compared to those without underlying health conditions (40 percent).

But researchers emphasized that this population was still below the Healthy People 2030 target in all states. 

In almost all states, flu vaccination rates for Black and Hispanic people were highest for seniors and lowest for non-elderly adults. Thirty states met or exceeded the 70 percent Healthy People 2030 target. 

For children aged six months to 17, just 10 states met or exceeded the national target rate, and no state reached the 70 percent target for non-elderly adults aged 18 to 64.

The findings could have major implications on COVID-19 vaccine distribution.

“While there are important distinctions between COVID-19 and seasonal flu, including that COVID-19 is much more serious, and the public’s receptivity to a COVID-19 vaccine may differ from that of the flu vaccine, these findings suggest there may be significant challenges to achieving equity in distribution and sufficient levels of immunity in the U.S. with a COVID-19 vaccine,” researchers stated.

They also noted that the lack of dedicated vaccination programs for uninsured adults compared to children, different access to health care, and the small number of states that mandate the flu vaccine, may affect overall vaccination uptake.

Additionally, the differences in funding and vaccine infrastructure by state and variation in levels of concern about vaccine safety, are other factors that could influence vaccine uptake as well. 

COVID-19 vaccine distribution may especially be a challenge for stakeholders looking to address racial and ethnic health disparities.

In mid-October, KFF released a report that found that 49 percent of Black Americans would not get a COVID-19 vaccine even if it was deemed safe by scientists and freely available. 

Safety concerns (39 percent) and distrust (35 percent) were cited as the top reasons. But a majority of Black adults also had little to no confidence that the vaccine development process was taking the needs of Black people into account.

Therefore, population immunity will be challenging and may not be reached without high flu vaccination rates across all communities. 

Once FDA has approved a COVID-19 vaccine authorized it for use, states will be responsible for its distribution throughout the US.

But despite the CDC’s recent guidance to states for preparing for a coronavirus vaccine, the overall success regarding vaccine distribution will differ significantly.