title: Racial and ethnic disparities in vaccination coverage among adult populations in the U.S.
abstract: BACKGROUND
  Reducing racial/ethnic disparities in immunization rates is a compelling public health goal. Disparities in childhood vaccination rates have not been observed in recent years for most vaccines. The objective of this study is to assess adult vaccination by race/ethnicity in the U.S.
  
  
  METHODS
  The 2012 National Health Interview Survey was analyzed in 2014 to assess adult vaccination by race/ethnicity for five vaccines routinely recommended for adults: influenza, tetanus, pneumococcal (two vaccines), human papilloma virus, and zoster vaccines. Multivariable logistic regression analysis was performed to identify factors independently associated with all adult vaccinations.
  
  
  RESULTS
  Vaccination coverage was significantly lower among non-Hispanic blacks, Hispanics, and non-Hispanic Asians compared with non-Hispanic whites, with only a few exceptions. Age, sex, education, health insurance, usual place of care, number of physician visits in the past 12 months, and health insurance were independently associated with receipt of most of the examined vaccines. Racial/ethnic differences narrowed, but gaps remained after taking these factors into account.
  
  
  CONCLUSIONS
  Racial and ethnic differences in vaccination levels narrow when adjusting for socioeconomic factors analyzed in this survey, but are not eliminated, suggesting that other factors that are associated with vaccination disparities are not measured by the National Health Interview Survey and could also contribute to the differences in coverage. Additional efforts, including systems changes to ensure routine assessment and recommendations for needed vaccinations among adults for all racial/ethnic groups, are essential for improving vaccine coverage.
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States. Electronic address: lhp8@cdc.gov.
authors.forename: Peng-jun
authors.initials: PJ
authors.lastname: Lu
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States.
authors.forename: Alissa
authors.initials: A
authors.lastname: O'Halloran
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States.
authors.forename: Walter W
authors.initials: WW
authors.lastname: Williams
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States.
authors.forename: Megan C
authors.initials: MC
authors.lastname: Lindley
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States.
authors.forename: Susan
authors.initials: S
authors.lastname: Farrall
authors.affiliation: Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States.
authors.forename: Carolyn B
authors.initials: CB
authors.lastname: Bridges
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007252:Influenza Vaccines; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines