Black-white disparities in 2009 H1N1 vaccination among adults in the United States: A cautionary tale for the COVID-19 pandemic. Burger, A. E., Reither, E. N., Mamelund, S., & Lim, S. Vaccine, January, 2021. 00000
doi  abstract   bibtex   
BACKGROUND: Prior research has highlighted racial and ethnic disparities in H1N1 vaccination in the United States. Our study adds to this literature by utilizing an intersectionality framework to examine the joint influence of race and sex on H1N1 vaccination beliefs and behaviors among non-Hispanic blacks and non-Hispanic whites (hereafter blacks and whites). METHODS: Using data from the National H1N1 Flu Survey of U.S. adults, we measured differences in beliefs about the safety and efficacy of the H1N1 vaccine among black women, black men, white women, and white men. We then estimated a series of nested logistic regression models to examine how race/sex vaccination disparities were influenced by health beliefs, socioeconomic status (SES), pre-existing conditions, and healthcare. RESULTS: Black respondents were more likely than white respondents to express reservations about the safety and efficacy of the H1N1 vaccine. Consistent with those beliefs, white females reported the highest rate of H1N1 vaccination (28.4%), followed by white males (26.3%), black males (21.6%), and black females (17.5%). Differences in health beliefs, SES, pre-existing conditions, and healthcare explained lower odds of H1N1 vaccination among white men and black men, relative to white women. However, black women experienced 35-45% lower odds of vaccination than white women across all models, highlighting the intersectional nature of these associations. DISCUSSION: The 2009 H1N1 influenza pandemic provides a cautionary tale about the distribution of new vaccines across large populations with diverse racial, sex, and socioeconomic characteristics. Despite differences between the H1N1 and COVID-19 pandemics, our study warns that many black Americans will forego COVID-19 vaccines unless swift action is taken to address black-white disparities in access to vital resources. Public health stakeholders can also encourage widespread adoption of COVID-19 vaccines by tailoring health promotion messages for different groups of racial minorities, especially groups like black women who face intersecting disadvantages.
@article{burger_black-white_2021,
	title = {Black-white disparities in 2009 {H1N1} vaccination among adults in the {United} {States}: {A} cautionary tale for the {COVID}-19 pandemic},
	issn = {1873-2518},
	shorttitle = {Black-white disparities in 2009 {H1N1} vaccination among adults in the {United} {States}},
	doi = {10/ghtrdc},
	abstract = {BACKGROUND: Prior research has highlighted racial and ethnic disparities in H1N1 vaccination in the United States. Our study adds to this literature by utilizing an intersectionality framework to examine the joint influence of race and sex on H1N1 vaccination beliefs and behaviors among non-Hispanic blacks and non-Hispanic whites (hereafter blacks and whites).
METHODS: Using data from the National H1N1 Flu Survey of U.S. adults, we measured differences in beliefs about the safety and efficacy of the H1N1 vaccine among black women, black men, white women, and white men. We then estimated a series of nested logistic regression models to examine how race/sex vaccination disparities were influenced by health beliefs, socioeconomic status (SES), pre-existing conditions, and healthcare.
RESULTS: Black respondents were more likely than white respondents to express reservations about the safety and efficacy of the H1N1 vaccine. Consistent with those beliefs, white females reported the highest rate of H1N1 vaccination (28.4\%), followed by white males (26.3\%), black males (21.6\%), and black females (17.5\%). Differences in health beliefs, SES, pre-existing conditions, and healthcare explained lower odds of H1N1 vaccination among white men and black men, relative to white women. However, black women experienced 35-45\% lower odds of vaccination than white women across all models, highlighting the intersectional nature of these associations.
DISCUSSION: The 2009 H1N1 influenza pandemic provides a cautionary tale about the distribution of new vaccines across large populations with diverse racial, sex, and socioeconomic characteristics. Despite differences between the H1N1 and COVID-19 pandemics, our study warns that many black Americans will forego COVID-19 vaccines unless swift action is taken to address black-white disparities in access to vital resources. Public health stakeholders can also encourage widespread adoption of COVID-19 vaccines by tailoring health promotion messages for different groups of racial minorities, especially groups like black women who face intersecting disadvantages.},
	language = {eng},
	journal = {Vaccine},
	author = {Burger, Andrew E. and Reither, Eric N. and Mamelund, Svenn-Erik and Lim, Sojung},
	month = jan,
	year = {2021},
	pmid = {33454136},
	note = {00000 },
	keywords = {Female, Humans, Male, Healthcare Disparities, United States, Adolescent, Adult, Middle Aged, Aged, Young Adult, Logistic Models, Health inequalities, Vaccination, Health Knowledge, Attitudes, Practice, Socioeconomic Factors, European Continental Ancestry Group, Social Class, Influenza, Human, Influenza Vaccines, COVID-19, Influenza A Virus, H1N1 Subtype, African Continental Ancestry Group, Vaccine hesitancy, Influenza vaccine, Racial disparities, 2009 H1N1, Intersectionality},
	annote = {Overall, rates of H1N1 vaccinations were low. White females (28.4\%), black females (17.5\%)
concern about H1N1 was higher among blacks ({\textgreater}60\% of black females and males reporting concern vs. 41\% of whites
blacks more concerned about potential adverse effects
investigation found that race and sex combined to produce important differences in vaccination uptake and beliefs during the 2009 H1N1 pandemic.
when controlling for demographic variables, socioeconomic status, chronic conditions, healthcare status, and health beliefs about H1N1, black females were less likely than white females (and other groups) to receive the H1N1 vaccine.
Additional knowledge regarding black-white disparities in vaccination behavior—and how this varies among men and women—is essential to minimize unequal uptake of COVID-19 vaccines in the U.S.
the strongest predictor of H1N1 vaccine uptake was a physician’s recommendation.
Even though physicians’ recommendations did not eliminate black-white vaccination disparities in our H1N1 analyses, especially among black women, recent improvements in health insurance coverage among blacks could, if sustained, facilitate contact with health care professionals who are likely to recommend properly vetted vaccines, including COVID-19, in the future
public health stakeholders could encourage widespread adoption of COVID-19 vaccines by continuing to educate Americans about the considerable health risks presented by this novel coronavirus—and by tailoring these health promotion messages for different groups of racial minorities, including black Americans.
There is an urgent need to promote covid-19 in communities of color
2009 H1N1 influenza pandemic nevertheless offers a cautionary tale about the distribution of new vaccines across large populations with diverse racial, sex, and socioeconomic characteristics
accounting for differences in educational attainment and marital status substantially reduced vaccination disparities between black males and white females
Understanding the causes of vaccine hesitancy during the 2009 H1N1 pandemic may help public health stakeholders reduce the disease burden created by COVID-19, particularly among black Americans and other racial/ethnic minorities.
 
intro:
A consistent theme in public health research is enduring disparities in health and health-related behavior —including vaccination uptake—by sociodemographic characteristics, especially race/ethnicity
a doctor’s recommendationand perceived susceptibility to H1N1 infection were the two strongest predictors of H1N1 vaccination},
	annote = {Vaccine . 2021 Jan 11;S0264-410X(20)31666-2. doi: 10.1016/j.vaccine.2020.12.069. Online ahead of print. Black-white disparities in 2009 H1N1 vaccination among adults in the United States: A cautionary tale for the COVID-19 pandemic},
	file = {Burger et al_2021_Black-white disparities in 2009 H1N1 vaccination among adults in the United.pdf:files/45101/Burger et al_2021_Black-white disparities in 2009 H1N1 vaccination among adults in the United.pdf:application/pdf}
}
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