Comparison of Seasonal Influenza Vaccination Uptake among Adult New York City Residents by Migration Characteristics

Background: Influenza is a vaccine preventable disease, but immunization rates remain suboptimal. In New York City (NYC), where 37% of the population is foreign-born, immunization uptake may be influenced by factors such as primary language spoken, health insurance, and the growing distrust of vaccines in certain world regions.

Methods: We used data from the 2010 NYC Community Health Survey (N=8582) to determine predictors of influenza vaccination among NYC residents. Chi-squared tests and logistic regression were used and all analyses were adjusted for complex sampling and weighted to the NYC population.

Results: Overall, 36.4% of immigrant residents received the vaccine, compared with 40.8% of the US-born population (p<0.01). Controlling for potential confounders, foreign-born New Yorkers were significantly less likely than US-born residents to have received the vaccine (adjusted odds ratio [aOR]=0.74, 95% confidence interval [95% CI]: 0.61-0.90). In the model restricted to immigrants, the odds of immunization were lowest among persons from the Caribbean (aOR=0.49, 95% CI: 0.25-0.88), Central Asia (aOR=0.54, 95% CI: 0.30-0.96), and the Middle East (borderline significance: aOR=0.50, 95% CI: 0.22-1.13), as compared to those from Europe. Hispanic or Asian ethnicity and having health insurance were significantly associated with higher odds of immunization.

Conclusions: Migrants from certain parts of the world where mistrust of vaccination is increasing were less likely to have received an influenza vaccine compared to those from Europe.  Specific immigrant subgroups might benefit from more targeted community outreach to identify and target the reasons for low influenza vaccination uptake.