Flu shots being administered at 35th Avenue and E. 12th Street in the Fruitvale in November 2020. Fewer people in Alameda County have been receiving flu shots during the 2022-2023 flu season, especially Black and Latino residents. Credit: Amir Aziz

When the Centers for Disease Control and Prevention in October warned of a gloomy flu season ahead for people of color, Emoadish Miles, 30, wasn’t moved. The mother of three, who works at a grocery store on 35th Avenue in Oakland, said she wasn’t planning to get the flu vaccine this year, no matter how dire health officials’ predictions. 

“Too many vaccines out there: monkeypox, COVID—just too many,” said Miles, who last got a flu shot in 2020. “My body needs a break.” 

Nationally, the percentage of Black people who received a flu vaccine during the 2021-2022 flu season was around 43%, according to the CDC.

The numbers have been lower during the 2022-2023 flu season for all groups. October 2022 CDC data on national flu vaccination coverage shows that roughly 23% of Black and Hispanic people have received an influenza vaccine, compared to 29% for white and non-Hispanic people.

In Alameda County so far this flu season, the vaccination rate has been even lower in Black and brown communities: around 13%, according to data from the California Immunization Registry provided to The Oaklandside by the Alameda County health department. By comparison, 27% percent of Asian and white residents in the county have been vaccinated against the flu so far this season.

The Alameda County health department is concerned the local trend could trigger an increase in flu-related deaths.

Neetu Balram, public information manager for the county health department, said the pattern is troubling—and all too familiar. “We see evidence of disparities among Black/African American and Latinx residents that also exist in COVID-19 vaccine uptake,” she said.

Health experts in the Bay Area say various factors are behind the low flu shot uptake in the Black community. Dr. Sumanth Rajagopal, head of infectious disease at Kaiser Oakland, said vaccine fatigue—like that described by Miles—is likely one of the reasons at play. 

“People are still emerging out of COVID-19. I think there is general vaccination fatigue,” he said. “We are gearing up our efforts, preparing for the worst.”

To encourage more community members to be vaccinated against the flu, Kaiser Oakland sent secure messages to about 1,500 of their Black patients in the Bay Area, advising that the vaccines are a lifesaver. The hospital also keeps records of patients’ flu updates. 

Some are concerned about the impact of big tech’s shifting free-speech policies on public health. Peter Chin-Hong, an infectious disease expert with the University of California, San Francisco, said the recent decision by Twitter’s Elon Musk to stop enforcing the tech giant’s policy of not allowing vaccine misinformation could open a can of conspiracy theories about the efficacy of these shots. 

“There is a direct pathway between misinformation and death,” he said. Chin-Hong warned of an escalation in flu hospitalizations among ethnic minorities “if science-based interventions like vaccines face rejection.”

While vaccine distrust or fatigue may apply to low flu-shot uptake in Oakland’s Black community, some public health researchers say those reasons don’t tell the whole story. 

Dr. Vickie Mays, a health policy and management professor at UCLA Fielding School of Public Health, said vaccine education efforts aimed at communities of color don’t always adequately take into consideration a community’s beliefs, culture, or understanding of health. 

Mays said a unique public health approach is needed to improve flu vaccinations in Black communities in cities like Oakland. “They need to have people who look like the people,” she said of public health messengers. “It’s education before vaccination.”

The CDC committed $156 million in federal funding to increase equity in immunization in 2020, with just one community health center in Oakland, La Clinica de La Raza, benefiting. 

Dr. Noha Aboelata, who heads Roots Community Health Center in East Oakland, said approaching health from an equity perspective can help to solve the perennial concern about low vaccination rates in Black and lower-income communities.

“We would have to center on the people most harmed, experiencing the most burden of disease,” she said during an interview in October about the lower COVID vaccine booster rates among Black residents in Oakland. “We must disproportionately concentrate resources where harm has been done. Most of this is structural, systemic, longstanding.”

Charles Ayitey is a broadcast reporter and narrative writer living in Oakland, California. His beat is on racial equities in health, business, and policy in the United States. Charles holds a Bachelor of Arts in Journalism from the Ghana Institute of Journalism (an affiliate of the University of Ghana) and expects to graduate from the UC Berkeley Graduate School of Journalism in May 2024. Before joining Berkeley J-School, Charles was a business anchor and writer at Joy News – a leading news organization in his hometown, Accra. He was awarded as the best business journalist in Ghana and the best climate reporter in Africa in 2021.