CDC: Uptake in Flu Vaccination is Down in Groups at High Risk for Complications

Drops in flu vaccine coverage this season have been recorded among young children and pregnant people and racial/ethnic gaps in uptake continue, says CDC.

The relatively mild 2021-2022 flu season seen in the US so far may be one factor contributing to concerning drops in vaccine coverage among people at increased risk for complications from the virus, according to a recent statement from the Centers for Disease Control and Prevention (CDC).

According to CDC monitoring systems, during-season flu vaccination uptake continues to show some "concerning" trends, with coverage lower from mid-October 2021 to the end of January 2022 compared with last season for most groups.

The contrast is of particular concern for groups at higher risk for severe infection or complications, including pregnant people and infants and young children. The CDC reports also that flu vaccination coverage was lower among racial and ethnic minorities compared not just with last season, but with seasons prior to the COVID-19 pandemic as well.

For all adults aged ≥18 years, influenza vaccination coverage as of January 29, 2022, was 44.3%. Coverage by age group:

  • 33.7% for adults aged 18-49 years,
  • 49.3% for adults aged 50-64 years
  • 66.6% for adults aged ≥65 years

The rates are overall similar to those seen during the previous season, CDC says, but also continue to include significant racial/ethnic disparities compared with vaccination coverage for White, non-Hispanic adults (49.3%) with lower rates recorded as follows:

  • 14% ↓ for Black, non-Hispanic adults (35.3%)
  • 15% ↓ for Hispanic adults (34.0%)
  • 13% ↓ for other/multiple races, non-Hispanic adults (36.4%)
  • 15% ↓ for American Indian/Alaskan Native, non-Hispanic adults (34.8%)
  • 14% ↓ for Pacific-Islander/Native Hawaiian, Non-Hispanic adults (35.7%)

The disparities repeat a similar pattern from one year ago and indicate the ongoing need for strategies to reach minority communities with information and/or resources that will help increase flu vaccine uptake.

Vaccination coverage among children aged 6 months to 17 years was down very slightly (3%) compared to the 2020-2021 season but down 7.4% when compared to the last flu season before the pandemic. Racial disparities in uptake in this younger population paralleled those seen among adults, the CDC reports. The positive signal, according to the agency, is that no additional drops were recorded, and gaps did not widen.

The high-risk group that has seen the largest drop in flu vaccine coverage to date is pregnant people, with coverage lower now than at this time last season overall by approximately 9% and across racial and ethnic groups, reports the CDC.

At the end of January 2022, pregnant people had estimated flu vaccine coverage of 51.4%, significantly lower than the estimated 60.1% at the end of January 2021. However, CDC points to the significant improvement from earlier in the season when data from October 2021 suggested an 18% drop from the year before.

Message fatigue?

Reasons for the drops in vaccine coverage are not fully understood yet, particularly as the vaccine supply has been “ample,” according to the CDC. The apparently low infection rate may impact individuals’ decisions to be immunized as could numerous factors related to fatigue over COVID-19 vaccine messaging including:

  • Confusion about the need for a flu vaccine this season or a belief that a COVID-19 vaccine will protect against flu.
  • Changes in health care seeking behavior that result in people making fewer visits to vaccine providers.
  • Fewer flu vaccination clinics compared with previous years related to vaccine fatigue pandemic-related vaccine fatigue

Flu activity this season increased from November through late December 2021 then declined through late January 2022. Flu indicators from the first 2 weeks of February, though, ticked upward, including percent of respiratory specimens testing positive for influenza at clinical laboratories and the reported numbers of flu hospitalizations.

Whether or not there will be significant influenza circulation again this season is an open question, but CDC continues to recommend a flu shot across populations as long as the viruses are circulating.