While the overall seasonal influenza vaccination rate remains low among adolescents with and without asthma, an asthma diagnosis is associated with an increased likelihood of influenza vaccination possibly because of increased health care use, according to study results published in the Journal of Asthma.

Despite longstanding recommendations for children with asthma to receive the influenza vaccine, uptake in this population remains low. Many factors may contribute to low vaccination rates, including socioeconomic status, lack of well visits and follow-ups during influenza season, lack of awareness about vaccine significance, and the public’s negative perceptions of vaccines.

Researchers used the NIS-Teen, a nationally representative survey that includes parental and health care provider reports of adolescents’ vaccination histories, to analyze the effect of comorbid asthma on adolescent influenza vaccination rates. Data were collected between 2016 and 2017 and analyzed in 2020.

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Of 36,655 adolescents in the analytic sample, 55% received 1 or more seasonal influenza vaccines in the past 3 years, and 21% had been diagnosed with asthma. On a bivariate analysis, influenza vaccination was more common among adolescents who had been diagnosed with asthma compared with those who were not (60% vs. 53%, P <.001). Adolescents with asthma were more likely to be older, non-Hispanic Black or White, have a high-risk condition for vaccination, and have more health care visits with the last year, compared with adolescents without asthma.

On multivariable analysis, asthma diagnosis was associated with greater likelihood of being up to date on seasonal influenza vaccination (P <.001). Older age and longer time since last well visit were associated with lower odds of being current on influenza vaccination, among continuous variables in the model.

The study had several limitations, the researchers were unable to evaluate the specific encounters (eg, well care vs acute care visit) during which adolescents received influenza vaccines, therefore it is unclear how the type of clinic (eg, primary care vs specialist) effects the likelihood that adolescents with asthma will be offered and accept the influenza vaccine.

The authors concluded that, “Despite concerns about vaccine effectiveness in children with asthma, this diagnosis was associated with increased likelihood of influenza vaccination, possibly in relation to increased health care use (and exposure to vaccine encouragement) among adolescents with asthma.”


Tran N, Cortright L, Buckman C, Tumin D, Syed S. Association between asthma and influenza vaccine uptake among US adolescents: a retrospective survey study. J Asthma. Published online March 24, 2021. doi:10.1080/02770903.2021.1908349