The Effect of Income Disparities on Influenza Vaccination Coverage in the United States

Objectives: Although influenza vaccinations are widely accessible, many people in the United States do not receive them as recommended by the Centers for Disease Control and Prevention. This study examined the relationship between income and receiving the influenza vaccination among US adults. Methods: We used 2014-2018 National Health Interview Survey data (N = 138 697). Adults self-reported whether they received a shot or nasal spray vaccine within the previous 12 months and their total family income. We used multivariable logistic regression to obtain odds ratios and 95% CIs. Results: Approximately 43% of adults reported receiving the influenza vaccine in the previous 12 months. After adjustment, adults in lower-income-level categories had decreased odds of influenza vaccine receipt compared with adults with a total family income >= $100 000. Specifically, adults with a total family income <$35 000 had 21% decreased odds of receiving the influenza vaccine (adjusted odds ratio = 0.79; 95% CI, 0.75-0.83). Conclusions: In this population of US adults, lower income levels were associated with decreased odds of influenza vaccine receipt. The relationship between income and receipt of the influenza vaccine may have important implications for future influenza vaccination efforts. Increasing influenza vaccination coverage among lower-income adults should be considered a public health priority.