HOUSTON — Only about half of U.S. patients with atherosclerotic cardiovascular disease receive annual influenza vaccine, and the rate is lower among Black and Hispanic patients than white ones.

Yet, researchers from Baylor College of Medicine and the Michael E. DeBakey VAMC, both in Houston, emphasized that the benefits of receiving an annual influenza vaccine among patients with ASCVD is well known.

“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,” according to their study. Results were published in the American Journal of Preventive Cardiology.1

The study team used 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. The focus was primarily on race/ethnicity and the relative difference in influenza vaccination by race/ethnicity for each U.S. state in the overall U.S. population.

About a fourth, 21%, of the 1.7 million patients in the study population were older than 65. They were 51% women, 63% white, 12% Black, 17% Hispanic and 9% with history of ASCVD.

Results indicated that the receipt of influenza vaccine was 38% in the overall population and 51% among those with self-reported ASCVD. That translates to approximately 97 million and 12 million US adults, respectively, according to the authors.

In terms of race and ethnicity, the receipt of influenza vaccine among ASCVD patients was 54% for whites, 45% for Blacks, and 42% for Hispanics (p<0.001). For comparison, 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.

For ASCVD patients, having an age older than 65 years, greater than college education, higher income and a primary care physician were significantly associated with higher odds of receipt of influenza vaccination, according to the report. On the other hand, being employed, lack of healthcare coverage, Black race and delay in healthcare access were significantly inversely associated with having received an influenza vaccine, it added.

“Only 50% patients with ASCVD receive influenza vaccines,” researchers advised. “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.”


  1. Al Rifai M, Khalid U, Misra A, Liu J, Nasir K, Et. al. 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. Am J Prev Cardiol. 2021 Mar;5:100150. doi: 10.1016/j.ajpc.2021.100150. Epub 2021 Jan 23. PMID: 33521756; PMCID: PMC7826080.