Flu Risks Greater for Racial Minorities

Last Updated March 2021 | This article was created by familydoctor.org editorial staff and reviewed by Deepak S. Patel, MD, FAAFP, FACSM

People from racial and ethnic minority groups are more likely to be hospitalized when they have the flu, according to a new analysis from the Centers of Disease Control and Prevention (CDC).

Minority groups at higher risk of health complications include non-Hispanic Black, non-Hispanic American Indian or Alaska Native, and Hispanic or Latino.

One reason these groups are at higher risk for flu hospitalization is because they are less likely to get a flu shot each year. Non-Hispanic white persons were most likely to get a flu shot. Hispanic or Latino persons were the least likely to get a flu shot, followed by non-Hispanic Black persons. The CDC reported these findings in FluVaxView.

There are many reasons for this racial disparity in health care and flu vaccinations:

  • Access to health care. Transportation and financial access are lower for minority groups and can discourage them from seeking medical care. This group is also less likely to have a usual source for health or dental care. Low-income individuals also may receive lower quality medical care, according to the Agency for Healthcare Research and Quality.
  • Increased exposure. Hispanic or Latino Americans are more likely to be exposed to the flu because they work jobs where they interact more with the public. Crowded work condition and living conditions, where they often live with extended family, also may increase their risk of exposure to the flu.
  • Being uninsured. The U.S. Department of Health and Human Services reports that only 55.5% of non-Hispanic Black Americans used private health insurance in 2017 compared to 75.4% of non-Hispanic white Americans.
  • Lack of trust in doctors and traditional medical care. Many studies point to a lack of trust in doctors, especially among non-Hispanic Black individuals. This group often reports feeling that doctors will not act in their best interest. For this reason, they are less likely to have their medical conditions under control. Unfortunately, they are also more likely to have serious medical conditions like high blood pressure and diabetes.

Path to improved health

The flu shot is the best way to protect yourself from the flu. But vaccine hesitancy among racial minorities continues to be high. A lack of trust in healthcare means that many minorities believe the flu vaccine is not safe. Many health groups are working to change these attitudes about the flu shot. They aim to educate minorities on the safety and benefits of getting the shot every year.

Vaccine safety

The flu vaccine is safe. There are very few side effects. After receiving the flu shot, your arm may be sore for a few days. You may have a low-grade fever, feel tired, or have sore muscles for a short time. If you received the nasal spray vaccine, you may have a runny nose, headache, cough, or sore throat.

In many cases, the flu shot will prevent you from getting the flu. If it doesn’t, it will lessen your risk of getting a severe case of the flu. This means you’ll be less likely to be hospitalized from the flu.

The CDC recommends that everyone 6 months and older get a flu vaccine every year. You should get the vaccine as soon as it becomes available each fall. You also can get it any time throughout the flu season (usually until March). It’s best to get it in the fall so that the vaccine can protect you throughout the flu season (about 6 months).

In the United States, flu activity peaks between December and February. The vaccine is available by shot or by nasal spray (LAIV4). The CDC recommends that people who have chronic conditions get the flu shot, not the nasal spray flu vaccine.

Flu vaccines work by exposing your immune system to an inactive (killed) form of the flu virus. Your body will build up antibodies to the virus to protect you from getting the flu. The nasal spray vaccine contains active but weakened viruses. You cannot get the flu from the flu shot or the nasal spray vaccine.

If you are 65 years of age or older, the CDC recommends that you get either a regular flu shot, a high-dose flu shot, or an adjuvanted flu shot. An adjuvant is an ingredient in the shot that makes it more effective. The high-dose and adjuvanted shots are designed especially for the 65-and-up age group.

Where can I get a flu shot?

There are many places that offer flu shots. Where you decide to get a flu shot will likely depend on location and cost.

Flu shots are available from your family doctor, from national pharmacies (such as CVS and Walgreens), at clinics, community health centers, urgent care centers, public health departments, colleges (free for students), some employers, and more.

Cost for the flu shot ranges from free to around $50, depending on whether you have insurance (private insurance, Affordable Care Act, Medicare Part B). If you do have insurance, most of the places listed above will offer you a flu shot at no cost to you.

If you do not have insurance, look for places offering discounted flu shots. Many national pharmacies offer coupons or other discounts for flu shots. Prices vary widely, so shop around. It can mean paying $19 or more than twice that. Look for online coupons, as well, or look for cost comparisons on GoodRx. Also, be prepared to pay up front before receiving the flu vaccination.

If you want help sorting out where to find a flu vaccine near you, there are online tools that can help. Try looking on vaccines.gov or VaccineFinder. Both use zip codes to help you narrow the search.

Things to consider

Not only are people in racial and ethnic minority groups more susceptible to the flu, they also have worse outcomes.

Complications from the flu can be lethal. If you have any of these emergency warning signs of flu sickness, you should seek medical care right away.

  • Difficulty breathing/shortness of breath
  • Chest pain/pressure that doesn’t go away
  • Dizziness or confusion
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or feeling unsteady
  • Fever or cough that improve but then return or get worse
  • Worsening of your chronic health condition

There are some people who should ask their doctor before getting a flu shot:

  • People who have had a severe allergic reaction to a flu vaccine in the past
  • People who have an allergy to eggs
  • People who previously developed Guillain-Barré Syndrome (a reversible reaction that causes partial or complete loss of movement of muscles, weakness, or a tingling sensation in the body) within 6 weeks of getting a flu vaccine

Note: Children younger than 6 months of age should not get a flu shot.

Questions to ask your doctor

  • Can I get the flu vaccine?
  • How do I know if I have the flu?
  • Am I at higher risk for flu complications?
  • What else can I do to protect myself from the flu?
  • What should I do if I have the flu?
  • Is it too late for me to get the flu shot?
  • Can I get the flu shot if I’m not feeling well?
  • Are there any vitamins of herbal remedies for the flu?

Resources

Familydoctor.org Flu Vaccine Booklet

Centers for Disease Control and Prevention: Flu Disparities Among Racial and Ethnic Minority Groups

U.S. Department of Health & Human Services

 

Funded by an unrestricted grant from Sanofi Pasteur.

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