Integrating Health Equity Into Annual Flu Vaccination Campaigns

People from racial and ethnic minority groups experience higher rates of severe influenza (flu). A CDC study examined differences in flu-related hospitalization rates, intensive care unit (ICU) admissions and in-hospital deaths by race and ethnicity during 10 flu seasons (2009–2010 through 2018–2019) and found: 

· Non-Hispanic Black people had the highest flu-related hospitalization rate (69 per 100,000) and the highest flu-related
ICU admission rate (12 per 100,000). 

· Non-Hispanic American Indian or Alaska Native people had the second-highest flu-related hospitalization rate (49 per 100,000) and the second-highest flu-related ICU admission rate (9 per 100,000). 

· Hispanic or Latino people had the third-highest flu-related hospitalization rate (45 per 100,000) and the third-highest
flu-related ICU admission rate (7 per 100,000 for each). 

· Disparities in severe flu outcomes were most significant in the youngest age group (0–17 years), with hospitalization, ICU and in-hospital mortality rates 1.3–4.4 times higher among racial and ethnic minorities 0–4 years of age than for non-Hispanic White children. 

· Let’s take a broad look at how organizations can integrate a health equity lens into their 2021–2022 flu vaccination campaigns. Traditional methods aren’t working. We must use different tactics to address social and demographic issues. 

Outreach and Engagement 

· Community-based care is critical. Addressing social barriers cannot be done solely in the clinical setting. 

· Outreach must be culturally sensitive and engagement materials must be tailored to target populations. 

Change Management  

· Engage health care and community leadership in using data to assess sociodemographic factors that influence
vaccination rates.  

· Align strategies with existing value-based risk-bearing contracts for a significant number of people with high-risk condition, subject to vaccine-specific or relevant quality measures.  

Identification and Screening 

· Leverage social factors or care management screenings or patient engagement touchpointsto identify immunization gaps. 

· Use communication and engagement tools to reinforce vaccination education. This could be through care management, for payers, or through trusted community touchpoints (e.g., food pantries), for CBOs. 

Navigation and Resource Connection 

· Use resource directory/referral management tools to: 

o Identify patients who have missed immunizations. 

o Generate referrals to a CBO for specific social services such as housing or transportation. 

· Incorporate immunization into patient engagement in social and clinical activities.  

· Consider cultural sensitivities and address barriers to or misperceptions about preventive care and immunizations. 

Social Health Team and Workflow  

· Leverage care team touchpoints, including social or community health workers, to educate patients on the benefits of immunization, and identify opportunities to facilitate vaccinations. 

· Use reminder recall programs to engage patients in vaccination activities. 

· Coordinate provider engagement strategies to clearly define immunization gaps and social barriers. 

· Develop workflows and provide appropriate staff training to promote screening and resource connections to CBOs. 

Community Partnerships 

· Use resource directory/referral management tools to: 

o Identify CBOs and track referrals and services fulfillment, such as immunization, social-barrier and vaccine education. 

o Develop community partnerships with CBOs to help close gaps in care, including for immunizations. 

Data and Evaluation 

· Facilitate methods of immunization and social information exchange in payer/provider/community partnerships to address social needs.  

· Assess program processes and outcomes, such as their impact on vaccination rates, social barriers and CBO services. 

To help combat disparities in flu vaccinations, organizations must implement action plans to increase vaccinations in communities with a history of lower flu vaccination rates and promote health equity, while acknowledging their responsibility for and influence in eliminating health disparities.  

What do you think? Share your thoughts in the Community Forum.  

1. How does your organization plan to implement flu vaccine outreach and health education for 2021–2022? How is it different from previous years?  

2. How is your organization leveraging data to raise awareness and communicate opportunities related to flu vaccine disparities?  

3. What clinical or operational challenges has your organization encountered when customizing or personalizing vaccine engagement to engage communities with historically lower flu vaccination rates? 

4. What strategies have helped your organization address flu vaccination disparities?