Disparities in influenza vaccination for U.S. adults with disabilities living in community settings by race/ethnicity, 2016–2021

Background: There is a paucity of data examining disparities in influenza vaccination at the intersection of disability and race. Objective: To compare the prevalence of influenza vaccination between U.S. adults (≥18 years) with and without disabilities living in community settings, and to examine changes in influenza vaccination over time by disability status and race/ethnicity groups. Methods: We analyzed cross-sectional data from the Behavioral Risk Factor Surveillance System (2016–2021). We calculated the annual age-standardized prevalence of influenza vaccination (last 12 months) in individuals with and without disabilities (2016–2021), and examined percentage changes (2016–2021) by groups of disability status and race/ethnicity. Results: From 2016 to 2021, the annual age-standardized prevalence of influenza vaccination was consistently lower in adults with disabilities as compared to those without disabilities. In 2016, 36.8% (95%CI: 36.1%–37.4%) of adults with disabilities had an influenza vaccine versus 37.3% (95%CI: 36.9%–37.6%) of those without disabilities. In 2021, 40.7% (95%CI: 40.0%–41.4%) and 44.1% (95%CI: 43.7%–44.5%) of adults with and without disabilities had an influenza vaccine. The percentage change in influenza vaccination from 2016 to 2021 was lower among people with disabilities (10.7%, 95%CI: 10.4%–11.0%; vs. no disability: 18.4%, 95%CI: 18.1%–18.7%). Among adults with disabilities, Asian adults reported the largest percentage increase in influenza vaccination (18.0%, 95% CI: 14.2%, 21.8%; p: 0.07), and Black, Non-Hispanics adults reported the lowest (2.1%, 95% CI: 1.9%, 2.2%; p: 0.59). Conclusions: Strategies to increase influenza vaccination in the U.S. should address barriers faced by people with disabilities, particularly the intersectional barriers faced by people with disabilities from racial and ethnic minority groups.