Editing Immunization (section)

==Race, ethnicity and immunization==
In the United States, race and ethnicity are strong determinants of utilization of preventive and therapeutic health services as well as health outcomes.<ref name="HUS">{{cite book |title=Health United States 2017 With special feature on mortality |date=2018 |publisher=National Center for Health Statistics |location=Hyattsville, MD}}</ref> Rates of infant mortality and most of the leading causes of overall mortality have been higher in African Americans than in European Americans. A recent analysis of mortality from influenza and pneumonia revealed that African Americans died of these causes at higher rates than European Americans in 1999–2018.<ref>{{cite journal |last1=Donaldson |first1=Sahai V. |last2=Thomas |first2=Alicia N. |last3=Gillum |first3=Richard F. |last4=Mehari |first4=Alem |title=Geographic Variation in Racial Disparities in Mortality From Influenza and Pneumonia in the United States in the Pre-Coronavirus Disease 2019 Era |journal=Chest |date=January 2021 |volume=159 |issue=6 |pages=2183–2190 |doi=10.1016/j.chest.2020.12.029|pmid=33400931 |doi-access=free }}</ref> Contributing to these racial disparities are lower rates of immunization against influenza and pneumococcal pneumonia.<ref name="HUS" /> During the COVID-19 pandemic, death rates have been higher in African Americans than European Americans and vaccination rates have lagged in African Americans during the roll-out.<ref>{{cite journal |last1=Bassett |first1=Mary T. |last2=Chen |first2=Jarvis T. |last3=Krieger |first3=Nancy |title=Variation in racial/ethnic disparities in COVID-19 mortality by age in the United States: A cross-sectional study |journal=PLOS Medicine |date=20 October 2020 |volume=17 |issue=10 |pages=e1003402 |doi=10.1371/journal.pmed.1003402|pmid=33079941 |pmc=7575091 |doi-access=free }}</ref> Among Hispanics immunization rates are lower than those in non-Hispanic whites.<ref>{{cite book |last1=Gorina |first1=Y |last2=Kelly |first2=T |last3=Lubitz |first3=J |last4=Hines |first4=Z |title=Trends in Influenza and Pneumonia Among Older Persons in the United States |date=2008 |publisher=National Center for Health Statistics |location=Hyattsville, MD}}</ref>