Influenza vaccination coverage among adults by nativity, race/ethnicity, citizenship, and language of the interview - United States, 2012-2013 through 2017-2018 influenza seasons

Published:September 11, 2021DOI:


      • Foreign-born persons in the U.S. make up approximately 15% of the population.
      • People who are foreign-born experience health care disparities.
      • Foreign-born adults had lower flu vaccine uptake than US-born adults in most seasons.
      • People interviewed in non-English languages had lower vaccine uptake English-speakers.
      • Strategies to improve flu vaccination uptake must consider foreign-born adults.



      Approximately 20,000 people died from influenza in the US in the 2019-2020 season. The best way to prevent influenza is to receive the influenza vaccine. Persons who are foreign-born experience disparities in access to, and utilization of, preventative healthcare, including vaccination.


      National Health Interview Survey data were analyzed to assess differences in influenza vaccination coverage during the 2012-2013 through 2017-2018 influenza seasons among adults by nativity, citizenship status of foreign-born persons, race/ethnicity, and language of the interview.


      Influenza vaccination coverage increased significantly during the study period for US-born adults but did not change significantly among foreign-born racial/ethnic groups except for increases among foreign-born Hispanic adults. Coverage for foreign-born adults, those who completed an interview in a non-English language, and non-US citizens, had lower vaccination coverage during most influenza seasons studied, compared with US-born, English-interviewed, and US-citizen adults, respectively.


      Strategies to improve influenza vaccination uptake must consider foreign-born adults as an underserved population in need of focused, culturally-tailored outreach. Achieving high influenza vaccination coverage among the foreign-born population will help reduce illness among the essential workforce, achieve national vaccination goals, and reduce racial and ethnic disparities in vaccination coverage in the US.

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