Flu vaccination rates vary widely by ethnicity in Canada

Influenza vaccination rates vary widely in Canada by ethnicity, with black and white Canadians being the least likely to be vaccinated, found a new study in CMAJ (Canadian Medical Association Journal).

Research on among ethnic minorities in Canada is scarce, despite many studies in the United States showing clear in vaccination rates among minorities and whites. However, the findings are not the same in Canada given existing differences in vaccine delivery and populations.

Canadian researchers undertook a study to estimate coverage across 12 in Canada. They looked at nationally representative data from the 2003, 2005, 2007, 2008 and 2009 cycles of the Canadian Community including 437 488 people aged 12 years and older. People representing 12 ethnic groups made up 18% of the sample.

The authors found that Canadians of Filipino (41%), Japanese (38%) and Chinese (35%) backgrounds had much higher vaccination rates than white Canadians (32%) and black Canadians (27%). In people with chronic disease, rates ranged from 34% to 50%.

"Our results show that all ethnic groups, with the exception of black Canadians, had significantly higher uptake of influenza vaccination than white Canadians," writes lead author Susan Quach and principal investigator Dr. Jeffrey Kwong and coauthors. "Variations in coverage levels persisted even after adjusting for other determinants of vaccine uptake, which suggests that there may be unique barriers and misconceptions influencing these groups differently."

The researchers suggest that the varying rates of vaccination between ethnic groups in Canada could be related to many reasons such as exposure to and support of antivaccination messages in the media.

"Our findings should not understate the importance of tackling issues of sociodemographics and access to health care that influence uptake and extend across all ethnic groups in Canada," conclude the authors. "To ensure optimal , it will be important for public health to work with health care providers, clients and community-based organizations to understand the unique challenges and barriers that affect their communities, and to design appropriate interventions for different populations."

The research was conducted at the Statistics Canada Research Data Centre and Public Health Ontario, with funding from the Canadian Institutes for Health Research (CIHR) and the Public Health Agency of Canada (PHAC) through the PHAC/CIHR Influenza Research Network.

In a related commentary, Dr. Bradford Gessner, Agence de Médecine Préventive, Paris, France suggests that local context may explain the varying rates of vaccination. "This may include access to vaccination programs, attitudes of local clinicians, access to the Internet, the importance of the antivaccine movement, media reporting and bias, actual or perceived prevalence of disease in a population, and assessment of individual risk."

"Rather than focus on race and ethnicity, I suggest a different approach," writes Dr. Gessner. "First, we should acknowledge that vaccination coverage for is low in almost all groups, the optimal target groups are not yet well-defined, and target groups and risk factors for low coverage will vary with place and time. For these reasons, national and local public health agencies should develop interventions that address risk factors at the appropriate level and for all people."

More information: www.cmaj.ca/lookup/doi/10.1503/cmaj.111628
Commentary: www.cmaj.ca/lookup/doi/10.1503/cmaj.120775

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