Newswise — Although there is high awareness of the need for seasonal influenza vaccines, a new study of Hispanics in one California county shows low rates of actual vaccination, especially among men.

“Previous national studies show that Hispanics have lower influenza vaccination rates than the general population, especially non-Hispanic whites,” said lead author Jeffrey Bethel, Ph.D., assistant professor in the Department of Public Health at East Carolina University in Greenville, N.C. “These are usually telephone-based surveys that may miss many lower-income people who don’t have landline telephones. We wanted to go door-to-door to get those being missed.”

Two hundred twenty-six Hispanic men and women 18 and older in three regions of San Diego County responded to the health care survey reported in the latest issue of the journal Ethnicity & Disease. A section of the survey looked specifically at awareness of seasonal flu concerns and vaccinations.

Overall, nearly 90 percent of those who responded were aware of guidelines suggesting that those over 65 years of age should get the seasonal flu vaccine. However, awareness was much higher among women than it was among men. There were also large gender differences among those who actually got the shot: nearly 26 percent more women than men age 65 received vaccinations.

“We found similar results among Hispanics in San Diego County in this study when compared to earlier national telephone surveys,” Bethel said. “We also found that Hispanic men had an even lower awareness and use of seasonal influenza vaccination compared to Hispanic women.”

This, he said, reinforces the need for culturally competent outreach in this group with a special emphasis on reaching males.

Luisa Borrell, D.D.S, an associate professor in the Department of Health Sciences at the City University of New York, said this research does a good job highlighting Hispanics’ flu vaccination outlook and participation. However, she thinks the study raises more questions than it answers.

“One of the concerns is that there was no indication of insurance coverage or access to care,” she said. “To me this is a key issue given the high proportion of Hispanics who said they were aware of the importance of vaccination, and the abysmal rates of people actually getting them.”

Given that they are aware of the importance of the seasonal influenza vaccines, Borrell said would have liked to know why Hispanics are not receiving vaccinations at a higher rate than they are. In her view, the crucial unanswered question of this study is: What is getting between the knowledge and the practice that keeps Hispanics away from the vaccines?

Ethnicity & Disease is a quarterly medical journal studying the ethnic patterns of disease. For more information, contact or visit

Bethel JW, Waterman SH. Knowledge, attitudes and practices regarding influenza prevention and control measures among Hispanics in San Diego County — 2006. Ethnicity and Disease 19(4), 2009.

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