Racial and Ethnic Disparities in Routine and Recommended Adult Vaccination Rates Among US Adults, National Health Interview Survey 2018

Reducing racial/ethnic disparities in vaccination rates is a significant goal of Healthy People 2030. This study aims to examine adult vaccination rates by race/ethnicity and sex in the United States. We evaluated the vaccination rate of influenza, tetanus-diphtheria (Td), hepatitis A, hepatitis B, pneumococcal, shingles, and human papillomavirus (HPV) using 2018 National Health Interview Survey (NHIS) data by race/ethnicity. Our sample included 53,647 participants, and we categorized race/ethnicity as White ( n  = 36,245), Black ( n  = 5,861), Hispanic ( n  = 8,219), and Asian ( n  = 3,322). Multivariate logistic regression was used to determine the association between race/ethnicity and vaccination coverage, controlling for demographic, socioeconomic, and health-related variables. We also stratified the multivariate logistic regressions by race/ethnicity and sex. Influenza, Td, hepatitis A, pneumococcal, and shingles vaccination coverage differed by race/ethnicity. After adjusting for key covariates, racial/ethnic disparities in vaccination persisted for all vaccines examined. Racial disparities in vaccination coverage persisted when stratifying by sex for all vaccines. Black males had lower odds of receiving the HPV and Td vaccine than White males (OR range: 0.53–0.78). Black females had lower odds of receiving the HPV, pneumococcal, and Td vaccine than White females while Hispanic and Asian females had lower odds of receiving the Td vaccine than White females (OR range: 0.52–0.76). Racial/ethnic and sex differences in vaccination levels narrow when adjusting for factors analyzed in the NHIS but are not eliminated, suggesting the need for efforts to achieve equity in immunization rates as well as increasing vaccination rates across all populations.