Only 48 percent of black senior citizens get flu shots, largely because of inaccurate and incomplete information about the flu itself, safety of inoculations, and ease and necessity of the shots.
Also contributing is a lingering distrust of public health inoculation programs, because of misinformation about the notorious 1932-72 Tuskegee syphilis studies of black men, says Lance Rintamaki, assistant professor of communications at the University at Buffalo, in a new study published in Health Communications.
Vaccination rates for non-Hispanic white seniors are 65 percent. The low percentage of inoculations for blacks is of concern to the medical community, Rintamaki says, because 44,000 U.S. residents 65 and older die from flu and its complications every year, compared with a total of 7,000 flu-related deaths in all other age groups.
The researchers found several reasons for the reluctance of older blacks to get flu shots. The study subjects did not understand how often they need to be vaccinated, Rintamaki says.
Some thought that, like vaccines against common childhood illnesses, the flu vaccine provided lifelong protection against the flu. Many did not know they needed to be re-vaccinated every year.
"The participants knew there are different strains of influenza," he says, "but they didn't realize they needed to be vaccinated against each strain as it turned up.
"Some also thought -- as do many members of the public -- that the vaccines cause the flu. If they became sick with a virus of one kind or other around the time they had a flu shot," he says, "they drew the erroneous conclusion that the shot made them sick.
"This is a common misperception and one that needs to be corrected," Rintamaki adds. "We often tell people the vaccine doesn't 'cause' flu but in failing to address why they might assume that it does, we leave the door open for them to think they are avoiding illness by avoiding the vaccine."
Better and more targeted messages and interventions are necessary to address concerns specific to older blacks and to emphasize how important it is for those in this age group to be vaccinated, the researchers say.
The study involved six focus groups of black seniors in the Chicago area. Their average age was 75, and 85 percent of them were women. They were asked to identify their current perceptions about influenza and influenza vaccination.
While 77 percent of participants said they had received a flu shot, only 50 percent had been vaccinated the previous year.
Despite the group size and the fact that their responses cannot be projected to the community as a whole, the authors say the results of the study confirm those conducted by the Centers for Disease Control and Prevention and others.
Some disturbing news to emerge from the study, says Rintamaki, is that the Tuskegee syphilis experiments continue to affect levels of trust among blacks about public health programs.
The Tuskegee experiments, whose original goal was to justify treatment programs for blacks, involved 399 black sharecroppers infected with syphilis.
In 1932, when the study began, the available treatments were highly toxic and of limited effectiveness. The study aimed to determine if patients were better off if they were not treated with those remedies. The researchers also wanted to study the efficacy of specific remedies for individual stages of the disease.
By 1947, penicillin was commonly used as an effective cure for the disease. The researchers, however, failed to treat study participants with the medication. As a result, many men died of syphilis, wives contracted it from husbands, and children were born with congenital syphilis. The study was not discontinued until news of this fact emerged, causing a public uproar.
Rintamaki points out that although the some of the seniors interviewed were not familiar with these experiments, those who were thought that the Tuskegee researchers did more than withhold treatment. They thought they actually injected the men with syphilis.
"The Tuskegee experiments have stirred fear and suspicion in the African American community over many health initiatives," he says, "and the suspicion they spawned has a continuing negative effect on the health of that community.
"In fighting the flu by encouraging inoculation, it is imperative that as health communicators we recognize that such fears exist and address such them," he says.