Flu vaccination rates vary by ethnicity

World Health Matters (Canada) – by Gary Finnegan – Influenza vaccination rates vary widely in Canada depending on ethnicity, according to a new study in the Canadian Medical Association Journal which shows that black Canadians and white Canadians are the least likely to be vaccinated.

Until now, research on vaccination rates among ethnic minorities in Canada has been scarce, particularly when compared to the large number of studies from the United States which show clear disparities in vaccination rates among minorities and whites.

However, while the findings from the Canadian study show variation across ethnic groups, the patterns they reveal are different to those seen in the US.

Researchers undertook a study to estimate influenza vaccine coverage across Canada by looking at nationally representative data from 2003, 2005, 2007, 2008 and 2009. The figures, taken from Canadian Community Health Surveys of 437,488 people aged 12 years and older, included people representing 12 ethnic groups.

The authors found that Canadians of Filipino (41%), Japanese (38%) and Chinese (35%) backgrounds had much higher vaccination rates than white Canadians (32%) and black Canadians (27%). In people with chronic disease, immunisation rates ranged from 34% to 50%.

“Our results show that all ethnic groups, with the exception of black Canadians, had significantly higher uptake of influenza vaccination than white Canadians,” lead author Susan Quach and principal investigator Dr Jeffrey Kwong wrote in their conclusion. “Variations in coverage levels persisted even after adjusting for other determinants of vaccine uptake, which suggests that there may be unique barriers and misconceptions influencing these groups differently.”

The researchers speculate that the varying rates of vaccination between ethnic groups in Canada could be due to anti-vaccination messages in the media, although it is unclear how this might relate to ethnicity.

The authors say socio-demographic issues and access to health care is known to influence vaccine uptake across all ethnic groups in Canada. “To ensure optimal vaccine coverage, it will be important for public health to work with health care providers, clients and community-based organisations to understand the unique challenges and barriers that affect their communities, and to design appropriate interventions for different populations.”

Commenting on the findings, Dr Bradford Gessner, Agence de Médecine Préventive, Paris, France suggested that local context may explain the varying rates of vaccination. “This may include access to vaccination programmes, attitudes of local clinicians, access to the Internet, the importance of the anti-vaccine movement, media reporting and bias, actual or perceived prevalence of disease in a population, and assessment of individual risk.”

He said that rather than focus on directly on race and ethnicity, health authorities should concentrate on interventions that affect vaccine uptake across all groups.