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Influenza Immunizations in Low-Income Communities

The purpose of the present review of literature is to gain a more in-depth insight into the causes of the insufficient influenza immunization rate among low-income communities and the existing solutions to managing the identified problem. The most effective interventions for overcoming low anti-flu vaccination levels will be singled out from the analyzed articles. Primary sources for the paper are peer-reviewed scholarly papers published within the past five years.

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Evidence from scholarly sources indicates that vaccination has a high potential to enhance health outcomes, prevent deaths, and promote well-being. At the same time, researchers emphasize the insufficient level of influenza immunization among low-income populations (Eskola et al., 2015; Orr and Beck, 2017). Whereas the American Academy of Pediatrics recommends vaccinating all children aged six months and older each year, only about 60% of children received the vaccine in the 2014-2015 flu season (Orr & Beck, 2017). African Americans and Hispanics/Latinos are reported to be immunized much less frequently than whites (Brown et al., 2018; Ngui et al., 2015; Orr & Beck, 2017). The most common reason for these population groups to be under-immunized is poverty, which leads to poor access to health services, the lack of insurance coverage, and inadequate knowledge of the need to vaccinate children (Brown et al., 2018; Ngui et al., 2015). As a result of remaining unvaccinated, children from low-income communities are more likely to develop not only influenza but also other dangerous diseases, which frequently cause fatal outcomes (Eskola et al., 2015). Therefore, data shows that the selected research question is of utmost importance.

While in general, the causes of under-vaccination are not quite clear, scholars single out several most substantial reasons. Most often, those parents who do not discuss the need to have their children vaccinated with the healthcare practitioner or are not informed about the adverse outcomes tend not to have their children immunized (Hofstetter et al., 2015a). Those caregivers from low-income communities who receive education on vaccination are more likely to have their children vaccinated for the first and subsequent times (Hofstetter et al., 2015b). Still, parental hesitancy is marked as one of the core reasons for the low immunization rate (Eskola et al., 2015; Orr & Beck, 2017). Therefore, there are two main directions to be addressed with the purpose of increasing the immunization rate among low-income communities: (1) promoting parents’ awareness of the vaccination’s benefits and dispelling the existing myths about immunization-related risks.

Research indicates that vaccinated children from low-income communities have a much lower tendency to develop influenza than those who are not immunized. A study by Smithgall et al. (2016) on the effectiveness of flu vaccination in low-income populations shows that 3.3% of influenza episodes as of the 2013-2014 season occurred among vaccinated individuals as opposed to 8.3% episodes among unvaccinated ones. Quinn et al. (2018) note that the rate of anti-flu vaccination among the Black population is much lower than among White citizens. Hence, it is understandable why these communities members do not tend to have their children vaccinated within the necessary terms. However, this circumstance increases the need to bring awareness about vaccination’s effectiveness to a higher level.

Scholars have identified several most typical interventions to increase low-income communities’ interest in flu immunization. Ngui et al. (2015) and Niccolai and Hansen (2015) have confirmed the positive effect of a social marketing immunization campaign. Eskola et al. (2015) emphasize the need to promote access to vaccination services among poorer population groups. Aigbogun et al. (2015) have substantiated the capability of reminder letters to elevate the rate of interest in immunization among low-income populations. Brown et al. (2018) have found a community health worker model effective in addressing the health disparities of low-income populations. Niccolai and Hansen (2015) have proved the effectiveness of such community- and practice-based interventions as school programs and physician-focused and reminder and recall practices. Although these scholars did not focus on influenza immunization, analyzing Hispanic health disparities in general (Brown et al., 2018) and human papillomavirus vaccination (Niccolai & Hansen, 2015), their findings are useful to employ in the current research.

The review of pertinent literature allows for making several crucial conclusions. Firstly, the current rate of low-income communities’ awareness of the need for influenza immunization and its benefits is not sufficient to prevent children and adults from poorer populations from flu-related mortality and morbidity. Secondly, along with spreading information on the effectiveness of vaccines, healthcare providers need to dismiss the existing myths about vaccines’ likelihood to harm people. Next, due to a variety of reasons, the level of knowledge about the time and frequency of vaccination among low-income communities is inadequate. The analysis of existing research studies has allowed for singling out the most typical problems related to the low-income population’s access to healthcare services. Based on the reviewed sources, the most viable intervention to eliminate the likelihood of the mentioned issues is education from a health provider along with reminders about vaccination times. This approach has been mentioned as successful in several of the articles concentrated on vaccination-increasing interventions.


Aigbogun, N. W., Hawker, J. I., & Stewart, A. (2015). Interventions to increase influenza vaccination rates in children with high-risk conditions—A systematic review. Vaccine, 33(6), 759–770. Web.

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Brown, L. D., Vasquez, D., Salinas, J. J., Tang, X., & Balcázar, H. (2018). Evaluation of Healthy Fit: A community health worker model to address Hispanic health disparities. Preventing Chronic Disease, 15. Web.

Eskola, J., Duclos, P., Schuster, M., & MacDonald, N. E. (2015). How to deal with vaccine hesitancy? Vaccine, 33(34), 4215–4217. Web.

Hofstetter, A. M., Barrett, A., & Stockwell, M. S. (2015a). Factors impacting influenza vaccination of urban low-income Latino Children under nine years requiring two doses in the 2010–2011 season. Journal of Community Health, 40(2), 227–234. Web.

Hofstetter, A. M., Vargas, C. Y., Camargo, S., Holleran, S., Vawdrey, D. K., Kharbanda, E. O., & Stockwell, M. S. (2015b). Impacting delayed pediatric influenza vaccination. American Journal of Preventive Medicine, 48(4), 392–401. Web.

Ngui, E. M., Hamilton, C., Nugent, M., Simpson, P., & Willis, E. (2015). Evaluation of a social marketing campaign to increase awareness of immunizations for urban low-income children. WMJ, 114(1), 10–15.

Niccolai, L. M., & Hansen, C. E. (2015). Practice- and community-based interventions to increase human papillomavirus vaccine coverage. JAMA Pediatrics, 169(7), 686. Web.

Orr, C., & Beck, A. F. (2017). Measuring vaccine hesitancy in a minority community. Clinical Pediatrics, 56(8), 784–788. Web.

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Quinn, S. C., Jamison, A., An, J., Freimuth, V. S., Hancock, G. R., & Musa, D. (2018). Breaking down the monolith: Understanding flu vaccine uptake among African Americans. SSM – Population Health, 4, 25–36. Web.

Smithgall, M., Vargas, C. Y., Reed, C., Finelli, L., LaRussa, P., Larson, E. L., Saiman, L., & Stockwell, M. S. (2016). Influenza vaccine effectiveness in a low-income, urban community cohort. Clinical Infectious Diseases, 62(3), 358–360. Web.

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StudyCorgi. (2022, June 27). Influenza Immunizations in Low-Income Communities.

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