Understanding Barriers to Flu Vaccination among American Indians in the Midwest

by Garrett Bates


The Healthy People 2020 initiative hopes to achieve a seasonal influenza vaccine coverage of 70% among people older than 6 months of age. However, vaccination coverage for the 2017 – 2018 year was only 36% among the clinically active population, those with 2 doctor visits within the past 3 years served by Indian Health Services (IHS), Tribal, and Urban (I/T/U) health facilities.

The current US census information for 2017-2018 states that 28,150 American Indians live in Kansas. Almost half are children under the age of 10 and people over the age of 60; thus about half the population are at risk for developing serious flu-related complications.

Issues: people perceive themselves to be healthy and not in need of the flu vaccine, negative beliefs about the vaccine effectiveness and adverse vaccine side effects, and people are unaware when and where they should get the flu vaccine.


  1. To determine if education of preventive medicine can lead to increased community acceptance of prevention efforts, such as, flu awareness and vaccine promotion.
  2. To determine effective methods of influenza and vaccine education among American Indian populations within Kansas for future implications.

Working with the Center for American Indian Community Health at KUMC, I will develop and conduct my study to reach these objectives.


I have created a survey for measuring flu education and vaccine awareness. It is based on a systematic review I did over past research. My study and the survey recently passed through IRB, thus now I’m beginning to gain participants and gather data. CAICH kindly donated 80 gift cards as incentives for people to take my surveys. My desired sample size is 80, but more would be great. However, at least 30 are needed. I plan to conduct surveys by going to different American Indian community events.

Reflection on lessons learned

So far, I realize I should have pushed myself to develop my project more in the early stages since IRB approval and gathering participants takes some time. I also have come to realize that the IRB process is extensive and to be as thorough as possible when developing my study.

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