OBJECTIVES:

Risk of the flu and its complications is higher in young children, elderly and pregnant women. American Indians and Alaska Natives (AIAN) are also at higher risk. The objective was to access the AIAN population’s vaccination status using data of electronic medical records (EMR) to provide insight for vaccination campaigns of this high-risk population.

METHODS:

AIAN subjects were identified in the TriNetX “Analytics” platform (TriNetX, Cambridge, MA), a live EMR database of >50M patients, mostly from the US (analysis 09-Jan-2020). Flu vaccination status (live, inactivated, a or b virus; 36 procedure and drug codes) and flu diagnoses (any virus strain; 20 ICD‑10 codes) were assessed between 01-Jul-2018 and 01-May-2019 in the AIAN population (overall and by age) and in the entire EMR population. All subjects had to have ≥1 healthcare visit during this period.

RESULTS:

The analysis included 60,668 AIAN subjects of whom 2,316 were aged <2 years and 8,691 were aged >65 years. Approximately 14.1% of all AIAN subjects (8,577/60,668) had a record of a flu vaccination. This percentage was 30.1 (698/2,316) in those aged <2 years and 14.8 (1,287/8,691) in those aged >65 years. Within all AIAN subjects, 1,946 (3.2%) subjects had an influenza diagnosis. There were 111 (4.8%) influenza diagnoses within subjects aged <2 years and 313 (3.6%) within subjects aged >65 years. Within the entire EMR population of 12.5M (all races combined), vaccination rates were 15% for all subjects, 28% in subjects aged <2 years and 18% within subjects aged >65 years.

CONCLUSIONS:

ANIN subjects have similar flu vaccination rates as seen in the overall EMR population. Vaccination rates may be underestimated when many persons receive vaccinations outside their healthcare organization (e.g. in pharmacies), and we assume no difference in the degree of underestimation by race. These results give healthcare providers current insights into this high-risk population.