Correlates of influenza vaccination among underserved Latinx middle-aged and older adults: a cross-sectional survey

Background: Vaccination is a powerful tool in the fight against seasonal influenza, among underserved, middle-age and older, Latinx adults. Yet, vaccine hesitancy and inconsistent uptake in this population continues to represent a substantial challenge to public health. A better understanding of factors impacting influenza vaccination behaviors in this group could result in more effective messaging and initiatives promoting universal vaccination among Latinx.

Methods: In this cross-sectional survey, we explore correlates of influenza vaccination uptake among underserved, Latinx, older adults. Our focus was on the role of socio-demographics, living arrangements, financial strain, access and satisfaction with medical care, and the presence of major chronic conditions in terms of vaccine uptake. Middle-aged and older Latinx residents diagnosed with diabetes and/or hypertension (n=165), were recruited from the South Los Angeles Service Plan Area (SPA), a historically under-resourced community. Bi-variate and multi-variate logistical regression were performed on survey data to explore independent correlates of influenza vaccination.

Results: Almost half of underserved Latinx older adults in our study (45%) reported influenza vaccination within the 12 months prior to the study. The majority (~85%) reported receiving this recommendation from their primary care provider. However, thirty percent (30%) of those receiving this advice did not get the vaccine. A decreased likelihood of vaccination was significantly associated with living alone (p-value=0.026), lacking Medicare coverage (0.028), or higher levels of financial strain (0.020). Difficulty accessing medical care (p-value=0.008) or dissatisfaction with these experiences (p-value=0.001) were also strongly associated with decreased likelihood of vaccination. Participants diagnosed with COPD had 9.5 (CI: 1.76 - 51.3) higher odds of being vaccinated compared to those without; no correlation was detected for other chronic conditions.

Conclusion: The high number of unvaccinated Latinx participants receiving a vaccine recommendation from a provider is consistent with studies among other ethnic/racial minority older adults and highlights the pivotal role of the provider in influenza vaccine adoption. Additional findings reflect negative impact of Social Determinates of Health on preventive care efforts in this group. Further efforts to quantify these associations are needed to explore structural and human factors impacting influenza vaccine uptake.