Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Go to the ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Racial and geographic disparities in influenza vaccination in the U.S. among individuals with atherosclerotic cardiovascular disease: Renewed importance in the setting of COVID-19.

Al Rifai M, Khalid U, Misra A, Liu J, Nasir K, Cainzos-Achirica M, Mahtta D, Ballantyne CM, Petersen LA, Virani SS. Racial and geographic disparities in influenza vaccination in the U.S. among individuals with atherosclerotic cardiovascular disease: Renewed importance in the setting of COVID-19. American journal of preventive cardiology. 2021 Mar 1; 5:100150.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions


Introduction: The importance of receiving an annual influenza vaccine among patients with atherosclerotic cardiovascular disease (ASCVD) is well established. With the rapid community spread and the possibility of another wave of COVID-19 infections in the fall, receiving an influenza vaccine is of particular importance to mitigate the risk associated with overlapping influenza and COVID-19 infections. Methods: We utilized cross-sectional data from the 2016 to 2019 Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative U.S. telephone-based survey of adults 18 years or older. Race/ethnicity was our exposure of interest. We assessed the relative difference in influenza vaccination by race/ethnicity for each U.S. state in the overall U.S. population and among those with ASCVD as prevalence of receipt of influenza vaccination among Blacks or Hispanics minus prevalence among Whites divided by prevalence among Whites. We used multivariable-adjusted logistic regression models to evaluate the association between socioeconomic risk factors and receipt of influenza vaccination. Results: The study population consisted of 1,747,397 participants of whom 21% were older than 65 years, 51% women, 63% White, 12% Black, 17% Hispanic, and 9% with history of ASCVD. The receipt of influenza vaccine was 38% in the overall population and 51% among those with self-reported ASCVD, which translates to approximately to 97 million and 12 million US adults, respectively. The receipt of influenza vaccine among individuals with ASCVD was 54% for Whites, 45% for Blacks, and 42% for Hispanics ( < 0.001). In the overall U.S. population, the median (interquartile range) relative difference for influenza vaccination between Blacks and Whites was 17% (-27%, -9%) and -22% (-29%, -9%) between Hispanics and Whites across all U.S. states. Among individuals with and without ASCVD, age older than 65 years, greater than college education, higher income, and having a primary care physician were significantly associated with higher odds of receipt of influenza vaccination, while being employed, lack of healthcare coverage, Black race, and delay in healthcare access were significantly inversely associated with having received an influenza vaccine. Conclusions: Only 50% patients with ASCVD receive influenza vaccines. The receipt of influenza vaccination among individuals with ASCVD is lower among Blacks and Hispanics compared to Whites with significant state-level variation. There are important socioeconomic determinants that are associated with receipt of the influenza vaccine.

Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.