Emergency departments could help boost annual flu vaccination rates

The findings, published in the Journal of Emergency Medicine, suggest that EDs could play an important role in increasing vaccine coverage, particularly among medically underserved populations.

The study also identified significant disparities in vaccination status. Patients without a primary care provider were more than twice as likely to be behind on influenza vaccination, with lower vaccination rates also seen in patients lacking insurance and African American patients.

Among participants who were not up to date on their flu vaccination, 37% said they would accept a flu shot if it were offered during their emergency department visit.

Dr. Rajesh Gulati, coauthor, professor of medicine, UCR School of MedicineEmergency departments are often the only point of contact with the health care system for many patients. Our findings show that there is a substantial opportunity to reach people who may not have access to primary care and help close important gaps in influenza vaccination coverage."

Influenza remains a major global public health threat, contributing to an estimated 650,000 deaths worldwide each year. Despite longstanding recommendations for annual vaccination, fewer than half of U.S. adults received a flu vaccine during the 2023–2024 season.

The researchers found that lack of primary care access was the strongest predictor of being behind on influenza vaccination. More than one in five study participants reported not having a primary care provider.

"These findings suggest that educational messaging and targeted outreach could further improve acceptance," Rodriguez said.

The cross-sectional study was conducted at EDs in Chicago, Detroit, Durham, Philadelphia, Fresno, Los Angeles, San Francisco, and Sylmar. The researchers surveyed adult patients regarding their knowledge of influenza vaccination, vaccination status, willingness to receive a flu shot in the emergency department, and reasons for vaccine acceptance or refusal.

"Emergency departments represent an underutilized venue for influenza vaccination surveillance, education, and vaccine delivery," Rodriguez said. "Expanding ED-based vaccination programs could help reduce influenza-related illness, hospitalization, and death, particularly among populations with limited access to routine health care."

The study was supported in part by the National Institute of Allergy and Infectious Diseases.

Rodriguez, Gulati, and Dhama were joined in the study by Shaokui Ge at UCR; Dr. Jesus Torres at UCLA; Dr. Brian Chinnock at UCSF Fresno; Dr. Michael Gottlieb at Rush University Medical Center, Illinois; Dr. Vijaya Arun Kumar at Wayne State University, Michigan; Dr. Kristin L. Rising and Dr. Efrat Rosenzweig Kean at the Thomas Jefferson University Hospital, Pennsylvania; Dr. Stephanie Eucker, at the Duke University School of Medicine, North Carolina; Dr. Melanie F. Molina at UC San Francisco.

Source:

University of California - Riverside

Journal reference:

Dhama, S., et al. (2026). Up to Date Status and Acceptance of the Influenza Vaccine among a National Sample of Emergency Department Patients. Journal of Emergency Medicine. DOI: 10.1016/j.jemermed.2026.05.011. https://www.jem-journal.com/article/S0736-4679(26)00157-5/abstract