Lower flu vaccination rates possible, though most adults agree flu shots protect against flu

Each year since 2019, the National Foundation for Infectious Diseases (NFID) has conducted a survey about certain vaccinations. As part of the survey, people are asked about how they feel about certain vaccinations, including flu shots, and whether they plan to get those vaccines.

This year, the survey included 1,000 adults aged 18 and older in the United States and was conducted in August 2023. Survey results show that 43% of all adults surveyed said they did not plan or that they weren’t sure they would get a flu vaccine this flu season. (In 2022, 49% of all surveyed adults had the same response.) For adults 65 years and older, 72% said they plan to get a flu shot, compared with only 52% of adults 18 to 64 years of age.

Despite many people saying they didn’t plan to get a flu shot or weren’t sure about it, 65% of all survey participants this year also said that an annual flu shot is the best way to prevent flu-related hospitalizations and deaths.

These survey results show that “the majority of people agree that flu vaccination will help prevent hospitalizations and death,” said NFID President Patricia A. Stinchfield, RN, MS, CPNP, at a September 28 news conference.

Yet “knowledge is one thing, behavior is another,” she added. “We really need to make sure our behavior catches up with what we know to be the best thing to do, and that’s to get vaccinated.”

Those people who said they weren’t planning or unsure about getting a flu vaccine this season gave several reasons, including two reasons that were given by survey participants last year:

  • Concern about potential side effects from the flu vaccine: This reason was given by 32%, a decrease from 39% who responded with this reason in 2022
  • A belief that flu vaccines don’t work very well: This reason was cited by 27%, down from 41% in 2022


Other reasons given for not planning to get a flu shot or feeling unsure about it included a mistrust of vaccines (31%) and concern about getting sick from vaccines (27%).

The survey also asked people about their plans to get vaccinated for COVID-19 and respiratory syncytial virus (RSV). (In 2023, RSV vaccines became available for the first time; people who are eligible for RSV vaccines include adults aged 60 years and older, using shared decision making with their healthcare provider, and pregnant people who are 32 to 36 weeks pregnant during RSV season.)

Survey participants had similar responses to those they provided about flu vaccination: Only 40% of adults said they planned to get an updated COVID-19 vaccine, while 40% of adults aged 60 years old and older said they planned to get a vaccine for RSV immunization.

“The data show that many U.S. adults are underestimating the seriousness of flu, COVID-19 and RSV,” Stinchfield said.

Flu vaccination rates for adults, children and pregnant people

The NFID survey results reflect a national trend toward lower flu vaccination rates in recent years. This trend spans many groups, as tracked by the Centers of Disease Control and Prevention (CDC).

Flu vaccination coverage for children in the 2022–2023 flu season was similar to the 2021–2022 season (57.4% vs. 57.8%, respectively). These rates are notably lower than vaccination rates in children recorded in 2019–2020 (63.7%).

For adults aged 18 years and older, coverage has steadily decreased, with 46.9% of adults receiving a flu vaccine in 2022–2023—a decline of 2.5% compared to 2021–2022 and 3.3% lower compared to 2020–2021. This decrease was noted across all adult age groups, although adults aged 65 and older have had the highest rates of vaccination among adults since at least 2010.

Pregnant people are some of the most likely to develop serious complications related to the flu. (Children younger than 5 years old and adults aged 65 and older are at higher risk for flu-related complications, too, as well as other people, like those who have compromised immune systems.) Unfortunately, flu vaccination rates have fallen very low in this group: Only 50.3% of pregnant people received a flu vaccine in the 2022–2023 flu season, compared with 65.5% of those in the 2019–2020 season.

Flu vaccination rates fall below national goals

While people are still getting vaccinated for the flu each season, the numbers still fall short of national goals for public health.

The Healthy People initiative, established by the U.S. Department of Health and Human Services (HHS) each decade since 1980, has established an objective to increase the amount of people who get the flu vaccine each year.

Unfortunately, the most recent data available on flu vaccination rates for people aged 6 months and older shows that the United States remains far below the desired rate of 70%. In the 2019–2020 flu season, 51.6% of all people eligible received a flu vaccine; in the 2020–2021 flu season, that number was slightly lower (49.8%). Ultimately, only about half of all eligible people are getting their flu vaccines.

How flu vaccination can help lower flu burden

While flu vaccination rates continue to be recorded, data is also being tracked to show the effect that flu vaccination can have on the disease burden of flu (illnesses, medical visits, hospitalizations and deaths related to the flu).

Each year, the CDC has used mathematical models to estimate the burden of influenza, as well as the effect that annual flu vaccination has on public health. Estimates of flu burden averted—that is, the estimated number of flu illnesses, medical visits, hospitalizations and deaths that are prevented by vaccination—are based on data on the burden of disease, vaccine coverage and vaccine effectiveness for each flu season.

For the 2021-2022 flu season, the CDC estimates that flu vaccines prevented:

  • 1.8 million symptomatic flu cases
  • 1 million flu-related medical visits
  • 22,000 flu-related hospitalizations
  • 1,000 flu-related deaths


Estimates for flu burden averted by vaccination in the 2022-2023 flu season have not yet been released on the CDC website. However, during the September 28 NFID news conference, CDC Director Dr. Mandy K. Cohen provided some preliminary data.

“Last season, we saw that the flu vaccine reduced the risk of flu-related hospitalizations among adults nearly in half, and among children nearly by three-quarters,” Cohen said. “New estimates that the CDC is putting out today show that last season, vaccines prevented more than 66,000 flu hospitalizations.”

So all this being said, getting a flu vaccine can have an important impact on your health this flu season. With rare exception, the CDC recommends that all people aged 6 months and older receive a flu vaccine by the end of October. If you haven’t received your flu vaccine yet, it’s not too late—talk to your healthcare provider before getting a flu shot. They can help determine whether a flu shot is right for you and help select an appropriate flu vaccine.

Find a place to get a flu vaccine near you