Striving to Improve Influenza Immunization Uptake in Hispanic Adults in New York State

December 08, 2017|10:53 a.m.| ASTHO Staff

While scientific data and the Centers for Disease Control and Prevention agree that the influenza (flu) vaccine is the best way to prevent and reduce the number and severity of illnesses caused by the influenza virus, lower flu vaccination coverage persists within the U.S. population and is even lower in racial and ethnic minorities. Specifically, in New York State, influenza and pneumonia is ranked in the top five leading causes of death among Hispanics, in part due to lower rates of vaccine coverage due to vaccine hesitancy. Vaccine hesitancy is a behavior in which individuals may delay or refuse vaccines due to a variety of factors including misconceptions or misinformation about vaccines, lack of general knowledge about vaccines, and other socio-cultural factors.    

In 2016, ASTHO partnered with the National Hispanic Medical Association (NHMA), the New York State Department of Health (NYSDOH) and the New York City Department of Health and Mental Hygiene (NYCDOHMH) to form a Community Action Team (CAT) to better understand and address the reasons behind the low vaccination rates among the Hispanic population in New York State to reduce vaccine hesitancy. Staff from the Bureau of Immunization at NYSDOH and NYCDOHMH joined the CAT and helped develop three priority strategies to address key barriers to vaccination and reduce vaccine hesitancy:

  • Utilize trusted sources of health information.
  • Increase provision of accurate information to the public.
  • Provide peer to peer support to medical providers.

Provider recommendation has been acknowledged as a strong motivator in patients obtaining a flu shot and reducing vaccine hesitancy. The CAT determined that providing new and existing flu-related resources and materials to trusted and visible healthcare providers who routinely serve the Hispanic communities in New York would help to improve influenza immunization uptake. Resources, including a health bulletin, vaccination toolkit, and healthcare provider influenza immunization toolkit, were promoted to healthcare providers through several mechanisms including social media platforms, email listservs, newsletters, as well as established communication systems such as Health Alert Networks. NHMA reported receiving approximately 12,000 Twitter impressions and approximately 3,000 Facebook views on promoted flu resources.   

The CAT also identified misinformation and misconceptions as major barriers to vaccine acceptance and factors leading to reduced vaccination rates. Culturally sensitive information and materials delivered in an appropriate manner can help promote obtaining the flu vaccination. Research indicates Hispanic adults utilize several different media types, but pay particular attention to social media, radio and television. The CAT identified several state and local mechanisms to disseminate current materials and resources to Hispanic communities to help combat misinformation and misconceptions about the flu, including public awareness campaigns, print materials, social media platforms, and text message platforms. The NYCDOHMH also held a press event at the Concord Baptist Church in Central Brooklyn on Oct. 31, 2017 to raise awareness about flu and promote flu vaccination. Mary Bassett, commissioner of health for the NYCDOHMH, and other flu champions spoke to New York City residents about the importance of flu vaccination. NYSDOH disseminated over 34,000 influenza and pneumococcal prevention posters and fliers, reaching approximately 56 percent of the counties NYSDOH serves.

Lastly, the CAT hosted two educational webinars for healthcare providers serving the New York Hispanic population to provide peer to peer support to empower healthcare providers to recommend the flu vaccine and address issues of vaccine hesitancy that might appear during medical appointments. The first webinar, Leveraging Public Health and Healthcare Provider Partnerships to Improve Influenza Immunization Uptake in Hispanic Communities in New York, focused on raising awareness on current flu trends and coverage rates, as well as strategies for healthcare providers to improve influenza immunization uptake among patients. The second webinar, Combating Myths and Misconceptions to Improve Influenza Immunization Uptake in Hispanic Communities in New York, highlighted ways for healthcare providers to incorporate cultural competency into flu immunization recommendations to reach high risk populations (such as pregnant women) and discussed tips on addressing patients’ and families’ concerns and misconceptions about the flu vaccine. Speakers for webinars included health department personnel, practicing providers, as well as identified flu immunization champions. This information can assist CAT members in understanding and improving immunization uptake statewide.

It is evident that the CAT model, demonstrated through this project in New York, successfully conducted several activities and efforts to improve flu vaccination uptake among Hispanic adults. The partnerships established and strengthened through the CAT allowed for greater dissemination of flu-related resources and pneumococcal disease prevention materials at both the state and local levels. When asked about impacts of the CAT initiative on New York State (NYS), Delia Easton, Ph.D., research scientist for the bureau of immunization at the NYSDOH, said “through the ASTHO CAT Initiative, NYSDOH increased the distribution of influenza and pneumococcal vaccine promotion materials to high-risk Hispanic women and their family members in New York State. The initiative also provided an invaluable opportunity to develop and distribute easy-to-read pneumococcal vaccine education materials designed to be useful for all NYS residents whose first language is not English. Other states would undoubtedly be able to augment immunization uptake efforts among vulnerable groups through utilization of a CAT Initiative.” The CAT model, which can be instituted in different states focused on different populations, also enabled peer-to-peer advocacy and education to help strengthen healthcare provider recommendations for influenza immunizations. CAT partners will continue efforts to improve flu immunization uptake and remain committed to reducing morbidity and mortality from flu and other immunization-preventable diseases in New York and across the United States.