Varying vaccination rates among patients seeking care for acute respiratory Illness: A systematic review and meta-analysis

Fadi Shehadeh, Ioannis M. Zacharioudakis, Markos Kalligeros, Evangelia K. Mylona, Tanka Karki, Robertus Van Aalst, Ayman Chit, Eleftherios Mylonakis

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background. Complications following influenza infection are a major cause of morbidity and mortality, and the Centers for Disease Control Advisory Committee on Immunization Practices recommends universal annual vaccination. However, vaccination rates have remained significantly lower than the Department of Health and Human Services goal. The aim of this work was to assess the vaccination rate among patients who present to health care providers with influenza-like illness and identify groups with lower vaccination rates. Methods. We performed a systematic search of the PubMed and EMBASE databases with a time frame of January 1, 2010, to March 1, 2019 and focused on the vaccination rate among patients seeking care for acute respiratory illness in the United States. A random effects meta-analysis was performed to estimate the pooled seasonal influenza vaccination rate, and we used a time trend analysis to identify differences in annual vaccination over time. Results. The overall pooled influenza vaccination rate was 48.61% (whites: 50.87%; blacks: 36.05%; Hispanics: 41.45%). There was no significant difference among gender groups (men: 46.43%; women: 50.11%). Interestingly, the vaccination rate varied by age group and was significantly higher among adults aged >65 (78.04%) and significantly lower among children 9-17 years old (36.45%). Finally, we found a significant upward time trend in the overall influenza vaccination rate among whites (coef. = .0107; P = .027). Conclusions. In conclusion, because of the significantly lower influenza vaccination rates in black and Hispanic communities, societal initiatives and community outreach programs should focus on these populations and on children and adolescents aged 9-17 years.

Original languageEnglish (US)
Article numberofaa234
JournalOpen Forum Infectious Diseases
Issue number7
StatePublished - Jul 1 2020


  • Acute respiratory illness
  • Influenza
  • Meta-analysis
  • Systematic review
  • Vaccination

ASJC Scopus subject areas

  • Oncology
  • Infectious Diseases


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