African-Americans Suffer From Vaccine Gap

According to the U.S. Department of Health and Human Services, African-American seniors are 30 percent less likely to get flu or pneumonia vaccines than white seniors. This could lead to more frequent hospital visits and even deaths. Host Michel Martin speaks with epidemiologist Mark Thompson, about why there's a vaccine gap.

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MICHEL MARTIN, HOST:

I'm Michel Martin and this is TELL ME MORE from NPR News. Coming up, we are going to return to the subject of forgiveness. Recently we talked about the benefits of forgiving people who have hurt you. But today we want to take a look at the other side of the equation. We want to talk about why there are times when it might be better not to forgive certain people, to keep them out of your life, including parents, as controversial as that might be. That conversation's coming up later in the program. First though, we are continuing today's focus on health. Right now we want to talk about vaccinations. Now, we're used to think about vaccinations as an important part of the health routine for children, but getting the right shots also has benefits for seniors, including shots for flu and pneumonia.

But according to the U.S. Department of Health and Human Services, African-American seniors are 30 percent less likely to get shots for the flu and pneumonia than white seniors. This could lead to more frequent hospital visits and even deaths in some cases. Here to tell us more about this is Mark Thompson. He is an epidemiologist with the Centers for Disease Control, the CDC. He studies vaccination rates and their effectiveness. Thank you so much for joining us.

MARK THOMPSON: Thanks for having me.

MARTIN: Overall, can we just talk about flu season overall? It's been a bear of a flu season. Now it's March, I think there's a perception that flu season is over. Is that true?

THOMPSON: It's definitely winding down, but this was one of the earliest and kind of worst flu seasons we've had in a while.

MARTIN: Overall, are seniors getting vaccinated at the rates that you would like, particularly for flu and pneumonia?

THOMPSON: The goal is 80 percent by 2020 and right now overall it's 60 percent. And for African-Americans it's running about 50 percent for seniors, so there's still a big gap there.

MARTIN: And why is that? What does your research tell you? Why might that be?

THOMPSON: Right. Well, African Americans are less likely to be insured or have a medical home, so one of the barriers is access, to being able to be in the doctor's office in the fall to get the vaccine. We've also found that in some studies African-Americans are more likely to have concerns about the vaccine, to believe in certain myths about the vaccine.

MARTIN: Like what?

THOMPSON: Well, I mean one of the common ones is that the vaccine can give you the flu. The fact is, is that the flu shot or the - actually has dead, killed vaccine - virus, I should say, and then the flu mist actually includes a weakened virus and neither of them can actually cause you to be sick.

MARTIN: Well, it's good that we can clear up that misconception right here and now. Is this vaccination gap between white and black Americans something that we see for all age groups or is this something that opens up for seniors?

THOMPSON: It's primarily a gap among seniors and also among pregnant women, but it has been seen in adults. Bit of a smaller gap there.

MARTIN: So let's talk about the benefits for getting these vaccinations. I mean one of the other things that I think people hear, though, and that is kind of discussed, you know, is that flu vaccination is actually less effective for seniors than it is for younger people. Is that true?

THOMPSON: Well, year in and year out, it's still the best protection - most important thing you can do to prevent flu. Some years it works better than others. This year it worked less than we had hoped, but still reducing risk by half or a third is still a really good thing.

MARTIN: Well, let's talk more about what are some of the reasons that seniors overall might be reluctant to get vaccinated. Is it the same issue, is it the same issue, it's just more pronounced in African-Americans, less likely to have a medical home, as you say, a regular doctor? Do seniors overall tend to have these suspicions about vaccinations or is this just something that tends to be with particular groups?

THOMPSON: No, I think you're right. These are common perceptions, maybe just a little bit more common among older adults, a little bit more common among African-Americans. But the truth is, we have, here in the U.S., an extremely safe vaccine and these kind of conventional wisdom kind of myths pop up and someone told you this or you heard that. In the fall there are lots of little viruses going around so, you know, occasionally someone gets a flu shot and they get sick the next day.

And well, they were going to get sick the next day anyway, but you make that connection and those, you know, those types of connections are hard to break and then when you tell other people, it kind of spreads.

MARTIN: Are there steps that are being taken now to get more seniors vaccinated, including the most skeptical African-Americans? Are there steps that you've seen that work particularly well and are there some things that you would want to talk about right now that you think would be helpful?

THOMPSON: Well, one of the things is getting better communication and education campaigns out there. The CDC's involved in that. And another thing is getting family members involved. My parents are getting older. One of the things that I try to do is I want to make sure I don't have any regrets about kind of taking care of them. Certainly one thing you can be sure, you know, each year you can do is get them vaccinated.

And again, it's not a perfect vaccine, but year in and year out it's the - it's effective to some degree, somewhere around a third to half in reducing the risk of medical visits. And in the last few years it's reduced the risk of hospitalization by about two-thirds among older adults. So you know, I spoke with someone recently who said, ah, this was - it just so happened to be the year I didn't get the vaccine and look, I ended up in the hospital.

And you know, that's the thing you want to avoid. You want to avoid having a parent or yourself having not done everything you could to prevent getting the flu.

MARTIN: And finally, in a minute we're going to hear from an older African-American about his experience joining a clinical trial. He had a career in the science field. He worked for NASA for many years, but even so he said that when this opportunity presented itself to him, he still had memories that he had to overcome. Is there something that could recommend that medical professionals or others might say or do to kind of overcome these very deep-seated fears that some people still have?

THOMPSON: Well, as you said, those are grounded in history and we have to recognize that. All institutions that do research now have institutional review boards that are extremely cautious and put up a lot of steps to make sure that patients and just the general public are protected. And so I think that's one thing that can be reassuring. And any study that somebody is asked to be involved with should involve some type of informed consent and that should be a dialogue where you have a chance to ask, you know, what's in it for me, what's the contribution to the society.

The contribution to the society is significant. The flu vaccine is a good example. We can't do randomized control trials in this country anymore because it's now recommended for everybody. And yet we have lots of new vaccines coming out, different types of flu vaccines, and the only way we're going to learn about those is if people volunteer, like they do in the studies I'm involved in, to be involved with those sorts of things.

And the contribution toward learning more, improving the vaccines we have, you know, that's a big contribution and I think older people care about that.

MARTIN: Mark Thompson is an epidemiologists from the Centers for Disease Control, the CDC. He was kind enough to join us from their studios in Atlanta. Mark Thompson, thank you so much for joining us.

THOMPSON: Thanks for having me.

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