Exclusive and dual influenza and COVID-19 vaccination among U.S. adults and adolescents in 2021

Figures & data

Table 1. Distribution of demographic and other characteristics among adults, National Health Interview Survey, United States, 2021.

	Weighted percent (95% CI)
Overall (n)	29,482
Age group (years)
18–29	20.2 (19.5, 21.0)
30–39	17.1 (16.5, 17.6)
40–49	16.0 (15.5, 16.5)
50–64	24.6 (24.0, 25.2)
≥65	22.1 (21.5, 22.8)
Sex
Male	48.3 (47.6, 49.0)
Female	51.7 (51.0, 52.4)
Race/ethnicity
NH White	62.8 (61.2, 64.3)
NH Black	11.7 (10.8, 12.6)
NH multi/other	8.6 (7.9, 9.4)
Hispanic or Latino	16.9 (15.6, 18.2)
Educational status
High school or less	37.8 (36.8, 38.8)
Some college and Associate degree	26.6 (25.9, 27.3)
College graduate (Bachelor’s degree)	22.5 (21.8, 23.2)
Above college graduate	13.1 (12.5, 13.7)
Poverty level
At or above	90.1 (89.5, 90.7)
Below	9.9 (9.3, 10.5)
Marital status
Married or living with a partner	61.1 (60.3,61.8)
Widowed/divorced/separated	14.8 (14.3,15.2)
Never married	24.1 (23.4, 24.9)
Region
Northeast	17.5 (16.3, 18.6)
Midwest	20.8 (19.6, 22.0)
South	37.9 (36.4, 39.5)
West	23.8 (22.3, 25.3)
Health Insurance
Yes	90.0 (89.5, 90.6)
No	10.0 (9.4, 10.5)
The usual place for healthcare
Yes	89.6 (89.1, 90.1)
No	10.4 (9.9, 10.9)
Hospitalizations within the past year
yes	8.2 (7.9, 8.6)
No	91.8 (91.4, 92.1)
High-risk condition^a
Yes	26.0 (25.4, 26.6)
No	74.0 (73.4, 74.6)
Previous COVID-19 diagnosis
Yes	13.5 (13.0, 14.1)
No	86.5 (85.9, 87.0)
Healthcare provider^b
Yes	3.3 (3.0, 3.6)
No	96.7 (96.4, 97.0)

NH: Non-Hispanic; CI: confidence interval.

^aAdults categorized as being at high risk for influenza-related complications reported one or more of the following: (1) ever being told by a physician that they had diabetes, emphysema, chronic obstructive pulmonary disease, coronary heart disease, angina, heart attack, or another heart condition; (2) receiving a diagnosis of cancer during the preceding 12 months (excluding nonmelanoma skin cancer) or ever being told by a physician that they had lymphoma, leukemia, or blood cancer; (3) being told by a physician that they had chronic bronchitis or weak or failing kidneys during the preceding 12 months; or (4) reporting an asthma episode or attack during the preceding 12 months.

^bAdults were classified as healthcare personnel if they reported that they currently volunteer or work in a hospital, medical clinic, doctor’s office, dentist’s office, nursing home, or some other healthcare facility, including part-time and unpaid work in a healthcare facility as well as professional nursing care provided in the home.

Figure 1. Distribution of Influenza and/or COVID-19 vaccination coverage among adults and adolescents 12–17 years, National Health Interview Survey, United States, 2021.

Table 2. Bivariate and multivariable analyses of adults’ receipt of influenza and/or COVID-19 vaccination, National Health Interview Survey, United States, 2021.

	Bivariate analysis				Multivariable analysis
	Exclusive influenza vaccination	Exclusive COVID-19 vaccination	Dual influenza and COVID-19 vaccination	Neither influenza nor COVID-19 vaccination	Exclusive influenza vaccination	Exclusive COVID-19 vaccination	Dual influenza and COVID-19 vaccination	Neither influenza nor COVID-19 vaccination
	% (95%CI)	% (95%CI)	% (95%CI)	% (95%CI)	aPR (95% CI)*	aPR (95% CI)*	aPR (95% CI)*	aPR (95% CI)*
Overall	6.0 (5.6, 6.4)	29.1 (28.3, 29.9)	42.5 (41.6, 43.5)	22.4 (21.5, 23.3)
Age group (years)
18–29	7.3 (6.2, 8.4)	31.1 (29.0, 33.2)	26.4 (24.4, 28.4)	35.2 (32.9, 37.5)	2.13 (1.59, 2.85)	1.41 (1.28, 1.56)	Ref	3.84 (3.36, 4.39)
30–39	7.2 (6.1, 8.3)	32.2 (30.4, 34.0)	30.1 (28.2, 32.0)	30.5 (28.6, 32.4)	2.13 (1.64, 2.77)	1.54 (1.40, 1.69)	1.03 (0.92, 1.15)	3.66 (3.19, 4.20)
40–49	5.6 (4.6, 6.6)	32.8 (30.9, 34.8)	34.9 (32.8, 36.9)	26.7 (24.8, 28.5)	1.62 (1.30, 2.02)	1.52 (1.41, 1.64)	1.22 (1.11, 1.34)	3.32 (2.92, 3.77)
50–64	5.6 (4.8, 6.3)	31.6 (30.2, 33.1)	46.4 (44.8, 48.0)	16.4 (15.3, 17.6)	1.53 (1.24, 1.89)	1.56 (1.45, 1.68)	1.60 (1.47, 1.74)	1.96 (1.72, 2.23)
≥65	4.5 (3.9, 5.1)	19.7 (18.5, 20.8)	67.6 (66.2, 69.0)	8.2 (7.4, 9.0)	Ref	Ref	2.24 (2.06, 2.44)	Ref
Sex
Male	5.0 (4.5, 5.6)	31.5 (30.3, 32.6)	39.2 (38.0, 40.5)	24.3 (23.1, 25.6)	Ref	Ref	Ref	Ref
Female	6.9 (6.3, 7.4)	27.0 (26.0, 27.9)	45.6 (44.3, 46.8)	20.6 (19.6, 21.6)	1.27 (1.10, 1.46)	0.90 (0.86, 0.93)	1.09 (1.06, 1.13)	0.96 (0.91, 1.02)
Race/ethnicity
NH White	6.0 (5.5, 6.5)	26.3 (25.4, 27.1)	46.6 (45.6, 47.7)	21.1 (20.1, 22.0)	Ref	Ref	Ref	Ref
NH Black	6.7 (5.3, 8.1)	33.2 (30.8, 35.7)	32.0 (29.5, 34.5)	28.0 (25.6, 30.4)	0.82 (0.66, 1.01)	1.24 (1.14, 1.36)	0.85 (0.79, 0.92)	0.99 (0.89, 1.09)
NH multi/other	4.0 (3.1, 5.0)	33.3 (30.8, 35.8)	48.2 (45.4, 51.0)	14.5 (12.3, 16.7)	0.69 (0.53, 0.89)	1.22 (1.13, 1.31)	1.11 (1.05, 1.18)	0.67 (0.59, 0.76)
Hispanic or Latino	6.1 (5.2, 7.1)	34.9 (32.6, 37.2)	31.4 (29.5, 33.4)	27.5 (25.3, 29.7)	0.76 (0.64, 0.90)	1.28 (1.18, 1.39)	1.00 (0.93, 1.08)	0.78 (0.70, 0.86)
Educational Status
High school or less	8.0 (7.2, 8.7)	27.4 (26.0, 28.7)	32.8 (31.5, 34.1)	31.9 (30.4, 33.4)	3.23 (2.35, 4.44)	0.92 (0.85, 0.99)	Ref	3.65 (3.17, 4.20)
Some college and Associate degree	6.7 (5.9, 7.5)	30.0 (28.5, 31.4)	38.9 (37.3, 40.4)	24.5 (23.1, 25.9)	2.54 (1.83, 3.53)	1.06 (0.99, 1.14)	1.09 (1.03, 1.15)	2.93 (2.52, 3.40)
College graduate (Bachelor degree)	3.9 (3.3, 4.6)	32.3 (30.7, 33.9)	50.8 (49.1, 52.6)	13.0 (11.9, 14.1)	1.60 (1.16, 2.21)	1.13 (1.05, 1.20)	1.43 (1.35, 1.51)	1.59 (1.35, 1.88)
Above college graduate	2.5 (1.9, 3.2)	27.1 (25.4, 28.9)	63.3 (61.3, 65.3)	7.1 (6.0, 8.1)	Ref	Ref	1.61 (1.53, 1.70)	Ref
Poverty level
At or above (ref)	5.5 (5.1, 5.9)	29.3 (28.4, 30.2)	44.2 (43.2, 45.2)	21.0 (20.1, 21.8)	Ref	Ref	1.29 (1.17, 1.41)	Ref
Below	10.0 (8.4, 11.6)	27.5 (25.2, 29.9)	26.8 (24.4, 29.2)	35.7 (33.0, 38.4)	1.39 (1.13, 1.69)	0.94 (0.85, 1.03)	Ref	1.23 (1.13, 1.34)
Marital status
Married	5.6 (5.1, 6.1)	28.2 (27.2, 29.2)	46.0 (44.8, 47.1)	20.2 (19.2, 21.2)	Ref	Ref	Ref	Ref
Widowed/divorced/separated	6.5 (5.6, 7.4)	26.7 (25.3, 28.2)	48.1 (46.3, 49.8)	18.7 (17.3, 20.1)	1.18 (0.96, 1.44)	1.09 (1.01, 1.17)	0.90 (0.86, 0.94)	1.20 (1.09, 1.32)
Never married	6.3 (5.4, 7.3)	33.1 (31.3, 35.0)	30.3 (28.5, 32.1)	30.2 (28.3, 32.2)	0.91 (0.71, 1.15)	1.08 (1.01, 1.15)	1.01 (0.96, 1.07)	0.91 (0.85, 0.98)
Region
Northeast	5.1 (4.2, 6.1)	30.3 (28.2, 32.4)	48.3 (46.0, 50.6)	16.2 (14.4, 18.1)	Ref	Ref	Ref	Ref
Midwest	6.3 (5.4, 7.2)	26.8 (25.4, 28.2)	44.2 (42.4, 46.1)	22.7 (21.1, 24.2)	1.05 (0.85, 1.31)	0.92 (0.83, 1.02)	0.97 (0.91, 1.04)	1.21 (1.06, 1.39)
South	6.7 (6.0, 7.4)	28.3 (26.9, 29.8)	38.4 (36.7, 40.0)	26.6 (25.0, 28.3)	1.13 (0.94, 1.35)	0.90 (0.82, 0.99)	0.89 (0.83, 0.94)	1.41 (1.24, 1.60)
West	5.1 (4.4, 5.9)	31.5 (30.0, 33.1)	43.3 (41.5, 45.2)	20.0 (18.3, 21.7)	1.01 (0.80, 1.27)	0.97 (0.88, 1.08)	0.97 (0.92, 1.02)	1.13 (0.98, 1.30)
Health insurance
Yes	5.9 (5.4, 6.3)	28.5 (27.7, 29.3)	45.9 (44.9, 46.8)	19.8 (19.0, 20.7)	Ref	Ref	Ref	Ref
No	6.8 (5.4, 8.3)	35.4 (32.5, 38.4)	12.3 (10.6, 14.1)	45.4 (42.4, 48.5)	0.97 (0.77, 1.21)	1.05 (0.93, 1.17)	0.43 (0.37, 0.51)	1.29 (1.17, 1.43)
Usual place for healthcare
Yes	6.1 (5.7, 6.5)	28.3 (27.5, 29.1)	45.5 (44.5, 46.5)	20.1 (19.3, 21.0)	Ref	Ref	Ref	Ref
No	4.7 (3.4, 5.9)	36.6 (33.8, 39.5)	16.2 (14.2, 18.2)	42.5 (39.5, 45.5)	0.72 (0.53, 0.99)	1.13 (1.02, 1.27)	0.54 (0.49, 0.60)	1.35 (1.22, 1.49)
Hospitalizations within the past year
yes	10.3 (8.7, 11.9)	21.8 (19.6, 24.1)	48.9 (46.3, 51.6)	19.0 (16.7, 21.2)	1.73 (1.45, 2.07)	0.83 (0.74, 0.93)	1.04 (0.98, 1.10)	0.96 (0.84, 1.09)
No	5.6 (5.1, 6.0)	29.8 (29.0, 30.7)	41.9 (40.9, 42.9)	22.7 (21.8, 23.6)	Ref	Ref	Ref	Ref
High-risk condition^a
Yes	6.3 (5.6, 7.1)	23.2 (21.9, 24.5)	55.8 (54.3, 57.3)	14.6 (13.5, 15.7)	1.11 (0.95, 1.29)	0.88 (0.82, 0.95)	1.18 (1.13, 1.22)	0.79 (0.73, 0.85)
No	5.8 (5.4, 6.3)	31.2 (30.2, 32.2)	37.8 (36.7, 38.9)	25.1 (24.1, 26.2)	Ref	Ref	Ref	Ref
Previous COVID-19 diagnosis
Yes	8.8 (7.4, 10.2)	28.3 (26.3, 30.3)	33.7 (31.7, 35.6)	29.2 (27.0, 31.4)	1.39 (1.11, 1.74)	0.93 (0.87, 1.00)	0.85 (0.80, 0.91)	1.23 (1.14, 1.33)
No	5.5 (5.1, 5.9)	29.3 (28.4, 30.1)	44.0 (43.0, 45.0)	21.2 (20.3, 22.1)	Ref	Ref	Ref	Ref
Healthcare provider^b
Yes	6.0 (3.8, 8.2)	25.5 (21.5, 29.5)	53.9 (49.4, 58.4)	14.6 (10.9, 18.3)	1.06 (0.71, 1.58)	0.84 (0.72, 0.99)	1.28 (1.17, 1.40)	0.70 (0.54, 0.89)
No	5.8 (5.3, 6.2)	30.0 (29.1, 30.9)	40.8 (39.8, 41.8)	23.4 (22.5, 24.4)	Ref	Ref	Ref	Ref

All percentages are weighted. NH: Non-Hispanic, aPR: adjusted prevalence ratio; CI: confidence intervals; ref: reference

*Adjusted for all variables in the table.

^aAdults categorized as being at high risk for influenza-related complications reported one or more of the following: (1) ever being told by a physician that they had diabetes, emphysema, chronic obstructive pulmonary disease, coronary heart disease, angina, heart attack, or another heart condition; (2) receiving a diagnosis of cancer during the preceding 12 months (excluding nonmelanoma skin cancer) or ever being told by a physician that they had lymphoma, leukemia, or blood cancer; (3) being told by a physician that they had chronic bronchitis or weak or failing kidneys during the preceding 12 months; or (4) reporting an asthma episode or attack during the preceding 12 months.

^bAdults were classified as healthcare personnel if they reported that they currently volunteer or work in a hospital, medical clinic, doctor’s office, dentist’s office, nursing home, or some other healthcare facility, including part-time and unpaid work in a healthcare facility as well as professional nursing care provided in the home.

Table 3. Distribution of demographic and other characteristics among parents of children 12–17 years, National Health Interview Survey, United States, 2021.

	Weighted percent (95% CI)
Overall (n)	3207
Child’s sex
Male	51.5 (49.4, 53.5)
Female	48.5 (46.5, 50.6)
Child’s Race/ethnicity
NH White	52.0 (49.5, 54.5)
NH Black	13.0 (11.2, 14.8)
NH multi/other	9.8 (8.7, 10.9)
Hispanic or Latino	25.2 (22.8, 27.5)
Child’s poverty level
At or above	84.2 (82.3, 86.1)
Below	15.8 (13.9, 17.7)
Region
Northeast	15.4 (13.6, 17.1)
Midwest	20.5 (18.6, 22.4)
South	40.6 (38.1, 43.0)
West	23.6 (21.3, 25.9)
Health insurance
Yes	95.3 (94.4, 96.2)
No	4.7 (3.8, 5.6)
Hospitalizations within the past year
yes	2.4 (1.7, 3.1)
No	97.6 (96.9, 98.3)
Usual place for healthcare
Yes	96.8 (96.0, 97.6)
No	3.2 (2.4, 4.0)
High-risk condition*
Yes	3.6 (2.7, 4.4)
No	96.4 (95.6, 97.3)
Previous COVID-19 diagnosis
Yes	11.6 (10.2, 12.9)
No	88.4 (87.1, 89.8)

NH: Non-Hispanic; CI: confidence interval.

*High-risk status was defined according to a parental report of 1 or more of the following: ever being told by a physician that the child had diabetes or reporting an asthma episode or attack in the past 12 months. This definition was based on Advisory Committee on Immunization Practices recommendations and the questions available in the NHIS.

Table 4. Bivariate and multivariable analyses of parental report of children’s (12–17 years) receipt of influenza and/or COVID-19 vaccination, National Health Interview Survey, United States, 2021.

	Bivariate analysis				Multivariable analysis
	Exclusive influenza vaccination	Exclusive COVID-19 vaccination	Dual influenza and COVID-19 vaccination	Neither influenza nor COVID-19 vaccination	Exclusive influenza vaccination	Exclusive COVID-19 vaccination	Dual influenza and COVID-19 vaccination	Neither influenza nor COVID-19 vaccination
	% (95%CI)	% (95%CI)	% (95%CI)	% (95%CI)	aPR (95% CI) *	aPR (95% CI) *	aPR (95% CI) *	aPR (95% CI) *
Overall	11.4 (9.4, 13.4)	26.4 (23.7, 29.0)	28.3 (25.6, 30.9)	34.0 (30.9, 37.1)
Child’s sex
Male	12.9 (10.1, 15.8)	25.8 (22.3, 29.3)	28.1 (24.6, 31.6)	33.2 (29.1, 37.3)	Ref	Ref	Ref	Ref
Female	9.7 (7.1, 12.3)	27.0 (23.2, 30.7)	28.5 (24.8, 32.2)	34.8 (30.5, 39.2)	0.75 (0.55, 1.03)	1.04 (0.86, 1.25)	1.00 (0.84, 1.19)	1.07 (0.92, 1.26)
Child’s Race/ethnicity
NH White	11.0 (8.4, 13.6)	23.1 (19.7, 26.4)	31.7 (28.0, 35.4)	34.2 (30.1, 38.3)	Ref	Ref	Ref	Ref
NH Black	13.5 (7.5, 19.6)	28.4 (20.0, 36.8)	18.2 (11.6, 24.8)	39.9 (31.2, 48.7)	1.12 (0.70, 1.81)	1.35 (0.98, 1.87)	0.61 (0.42, 0.90)	1.04 (0.78, 1.38)
NH multi/other	12.4 (6.7, 18.0)	27.0 (20.5, 33.5)	36.7 (28.8, 44.6)	24.0 (16.0, 31.9)	1.15 (0.71, 1.86)	1.14 (0.84, 1.54)	1.16 (0.91, 1.47)	0.72 (0.49, 1.05)
Hispanic or Latino	10.8 (7.0, 14.6)	32.2 (26.5, 37.9)	22.8 (18.3, 27.3)	34.2 (28.2, 40.1)	0.92 (0.58, 1.44)	1.46 (1.21, 1.76)	0.79 (0.63, 1.00)	0.91 (0.75, 1.11)
Child’s Poverty level
At or above (ref)	11.1 (8.9, 13.2)	27.2 (24.5, 30.0)	30.2 (27.0, 3, 33)	31.6 (28.4, 34.7)	Ref	Ref	Ref	Ref
Below	13.2 (8.0, 18.5)	21.3 (14.5, 28.2)	17.2 (11.8, 22.6)	48.2 (39.4, 56.9)	1.28 (0.86, 1.91)	0.71 (0.53, 0.96)	0.60 (0.42, 0.85)	1.56 (1.26, 1.94)
Region
Northeast	12.6 (7.1, 18.0)	32.0 (24.0, 39.9)	34.2 (26.1, 42.4)	21.3 (13.2, 29.3)	Ref	Ref	Ref	Ref
Midwest	10.7 (7.1, 14.4)	22.8 (17.4, 28.1)	29.5 (23.7, 35.2)	37.0 (30.3, 43.8)	0.84 (0.48, 1.48)	0.75 (0.51, 1.09)	0.82 (0.57, 1.17)	1.79 (1.21, 2.65)
South	12.5 (9.5, 15.5)	24.7 (20.5, 28.8)	23.7 (19.9, 27.5)	39.1 (34.0, 44.2)	0.95 (0.55, 1.62)	0.74 (0.55, 0.99)	0.78 (0.58, 1.05)	1.79 (1.21, 2.64)
West	9.3 (4.4, 14.2)	28.9 (23.5, 34.4)	31.3 (25.5, 37.1)	30.5 (24.4, 36.5)	0.76 (0.35, 1.67)	0.87 (0.63, 1.20)	0.94 (0.67, 1.31)	1.44 (0.95, 2.19)
Health insurance
Yes	11.3 (9.2, 13.3)	26.3 (23.6, 29.0)	29.0 (26.3, 31.8)	33.4 (30.3, 36.5)	Ref	Ref	Ref	Ref
No	15.5 (5.8, 25.1)	31.4 (17.7, 45.1)	9.0 (5.0, 13.1)	44.0 (28.5, 59.5)	1.15 (0.49, 2.69)	1.16 (0.78, 1.72)	0.42 (0.21, 0.82)	1.18 (0.91, 1.52)
Hospitalizations within the past year
Yes	6.4 (0.9, 11.9)	23.0 (13.4, 32.6)	43.6 (29.5, 57.6)	27.0 (12.0, 42.0)	0.57 (0.20, 1.62)	0.92 (0.49, 1.73)	1.66 (1.17, 2.35)	0.73 (0.42, 1.25)
No	11.6 (9.5, 13.6)	26.5 (23.8, 29.1)	27.8 (25.0, 30.5)	34.2 (31.0, 37.4)	Ref	Ref	Ref	Ref
Usual place for healthcare
Yes	11.1 (9.1, 13.1)	26.4 (23.7, 29.1)	28.9 (26.1, 31.6)	33.6 (30.5, 36.7)	Ref	Ref	Ref	Ref
No	20.5 (0.1, 40.9)	24.3 (14.3, 34.4)	9.6 (1.5, 17.8)	45.5 (26.0, 65.1)	1.80 (0.69, 4.70)	0.83 (0.47, 1.47)	0.44 (0.21, 0.91)	1.25 (0.84, 1.86)
High-risk condition^a
Yes	12.3 (3.2, 21.4)	13.4 (1.4, 25.4)	34.2 (22.8, 45.6)	40.1 (26.2, 54.1)	1.08 (0.51, 2.29)	0.53 (0.23, 1.20)	1.32 (0.87, 1.98)	1.07 (0.73, 1.57)
No	11.3 (9.3, 13.4)	26.9 (24.2, 29.6)	28.0 (25.3, 30.8)	33.7 (30.6, 36.9)	Ref	Ref	Ref	Ref
Previous COVID-19 diagnosis
Yes	15.5 (9.3, 21.6)	24.4 (18.0, 30.7)	21.5 (15.3, 27.7)	38.7 (29.8, 47.5)	1.45 (0.91, 2.31)	0.91 (0.69, 1.22)	0.69 (0.53, 0.90)	1.23 (0.95, 1.58)
No	10.8 (8.7, 12.9)	26.7 (23.9, 29.4)	29.3 (26.4, 32.2)	33.3 (30.1, 36.4)	Ref	Ref	Ref	Ref

All percentages are weighted. NH: Non-Hispanic; aPR: adjusted prevalence ratio; CI: confidence intervals; ref: reference. 

*Adjusted for all variables in the table.

^aHigh-risk status was defined according to a parental report of 1 or more of the following: ever being told by a physician that the child had diabetes or reporting an asthma episode or attack in the past 12 months. This definition was based on Advisory Committee on Immunization Practices recommendations and the questions available in the NHIS.

Data Availability

The data that support the findings of this study are openly available at https://www.cdc.gov/nchs/nhis/data-questionnaires-documentation.htm