The partisan split in flu vaccine uptake has widened as the United States braces for what could be its worst flu season since the covid pandemic began.
A third of U.S. adults have gotten a flu shot this fall — including 49 percent of Democrats and 22 percent of Republicans, according to a new Harris-Grid poll. Just over a quarter of adults do not plan to get the flu vaccine this year, the poll found, but that rises to 37 percent among Republicans. Thirty percent of adults said they will get the shot, and 9 percent are unsure.
Getting vaccinated against influenza did not used to be so polarizing, said Rupali Limaye, a behavioral scientist at the Johns Hopkins Bloomberg School of Public Health. While rates of flu vaccination started slowly diverging along party lines several years before 2020 — the Democrat-Republican split was 67-51 in 2019, the poll found — the gap has only grown wider since the pandemic, reaching a 24-point difference in 2021.
“It’s in line with what we’re seeing in terms of covid vaccine uptake, with far fewer Republicans getting the covid vaccine,” Limaye said. Covid’s impact showed up in the poll, with 18 percent of Republicans reporting that the pandemic has made them less likely to receive a flu vaccine each year, the poll found, compared with just 7 percent of Democrats. The forces driving this split are complex.
“To me, the issue here is not necessarily that people are anti-science,” Limaye said, “it’s that people are trying to stay in line with their political ideologies, and for Republicans, vaccines have become a casualty of that; they see vaccines as a symbol of the government telling you what to do.”
That sentiment was around before covid, but polarization around pandemic measures has only elevated vaccines as an emblem of political identity. Mis- and disinformation about the safety and efficacy of covid vaccines has also fueled that rise, said Adriane Casalotti, chief of government and public affairs at the National Association of County and City Health Officials. “To see it play out here, in the unrelated flu vaccine, just shows how much work needs to be done to build back trust in vaccines overall,” she said.
The growing partisan divide could have worrying consequences for this flu season and those to come.
Flu came roaring back in parts of the southern hemisphere after two years of relative quiet, potentially previewing a bad flu season in the U.S. this winter. Already there are signs that the influenza virus is getting an early start here. With another covid surge looming, vaccination is the best way to keep hospitals from being overwhelmed, Casalotti said. Many health systems are still understaffed as burned-out nurses and other healthcare workers leave the bedside.
A dip in Republicans willing to get vaccinated lowers the overall influenza vaccination rate, which could increase hospitalizations and deaths. But given political sorting in where people live, this gap could put an extra strain on hospital systems in Republican-leaning communities, Casalotti said. If this gap persists, vaccination programs, including school or workplace pop-ups, might shut down in some places, Casalotti said, translating a few years of lower uptake into more permanent reductions in access.
The consequences of covid vaccine polarization have proved significant, with lower uptake likely contributing to 76 percent higher death rates among Republicans than Democrats since vaccines became available, according to a National Bureau of Economic Research analysis released last month. Flu is less deadly than covid, but it still kills between 12,000 and 50,000 people each year in the U.S. Lower vaccine uptake would worsen influenza’s impact.
Reversing this trend will prove challenging, Casalotti said, but local health departments can play a crucial role. Ensuring broad and easy access to vaccines while relying on trusted community members to communicate the benefits of getting vaccinated will be crucial, she said.
But in an environment where leading politicians routinely take aim at basic public health measures, local officials are fighting an uphill battle, she said: “When you actively try to dismantle trust in public health, the implications go far beyond covid.”
Thanks to Lillian Barkley for copy editing this article.