Health Insurance

The Flu Shot Debate: Most Won’t Get It, Yet Think it Should Be Mandatory

The Flu Shot Debate: Most Won’t Get It, Yet Think it Should Be Mandatory

A startling number of Americans haven't decided to get a flu shot this year. Here's what's stopping them.
Flu shot
Flu shot Source: Getty Images

Despite doctors recommending flu shots for nearly all healthy individuals, a startling 43% of Americans have not yet committed to getting a flu shot this year. That may partially explain why Americans incur $10.4 billion in medical costs associated with the flu each year, with an estimated 810,000 hospitalizations and 61,000 deaths in just the 2017–2018 flu season.

Key findings

  • 74% of people declining a flu shot this year are doing so over concerns with the flu shot's effectiveness or safety.
  • Middle-aged people are least likely to be convinced of a flu shot's effectiveness: Only 40% of people ages 39–53 think it works. Older people get flu shots more often than younger people, but those who skip it are typically skeptical of the shot's effectiveness.
  • Cost is not a significant factor for most people who don't get a flu shot, but skipping a flu shot is very expensive for the country ($10.4 billion spent annually). And the typical cost of a flu shot is just $20–$40, even without health insurance.
  • People are split about whether employers should require flu shots, but people who've gotten sick from their coworkers are more likely to agree — 63% of those people said it should be required.

Who is getting a flu shot this year? Who isn't?

Among our survey respondents, 57% of people are planning on getting a flu shot this year, or have already done so.

Overall, men and women are about equally likely to get a flu shot — 59% for men, 56% for women. However, willingness to get a flu shot increases with age among women, while men were more consistent as they aged. In our data, older women planned on getting flu shots at a rate 134% higher than women aged 18 to 22.

Line graph comparing the frequency of people's intentions to get a flu shot by age and gender

Line graph comparing the frequency of people's intentions to get a flu shot by age and gender

Why not? Concerns over effectiveness and safety are key for most

However, people without health coverage worried over price much more often

Most people who did not get a flu shot did so out of concern for the effectiveness or safety of the flu shot, not cost. Only 12% of people who aren't planning to get a flu shot are skipping it because of cost reasons, while 74% cited "Don't think it works," "Flu shot makes me sick" or "Concerned about what's in the shot" as reasons.

People without health insurance are vastly more likely to be concerned about the cost of flu shots than insured people. Uninsured Americans were 2.5 times more likely to agree that they "want to get a flu shot, but can't afford it." And they were more than 6.5 times more likely than people with insurance to decline getting a flu shot over cost reasons.

The cost of a flu shot at major pharmacies without insurance ranges from around $20 (Costco) to $40 (Target, Walgreens and Rite-Aid). Most health insurance policies completely cover the cost of flu shots, while others require a small copay.

The Centers for Disease Control estimates the flu costs $10.4 billion in direct medical expenses in the U.S. each year. That's $495 for each person who saw a doctor for the flu in 2017–2018. And for people without health insurance, the total cost would fall to them directly.

Bar chart showing reasons people have chosen not to get a flu shot

Bar chart showing reasons people have chosen not to get a flu shot

Gen X is most skeptical of the flu shot's effectiveness

Millennials and baby boomers tended to agree that the flu shot is effective, but middle-aged respondents were more likely to feel that it didn't work. A relatively consistent group (20% on average) were unsure of the shot's effectiveness.

Stacked line chart showing the relative proportions of people who think the flu shot is effective by age
Stacked line chart showing the relative proportions of people who think the flu shot is effective by age

Should the flu shot be mandatory?

People who have gotten sick from their co-workers are more likely to agree.

One of the best indicators of whether someone is getting a flu shot this year is whether they've gotten the flu in the past: 62% of people who have gotten the flu in past years are planning to get the shot this year, compared to just 46% of people who haven't had the flu.

Most people think they have "gotten sick because of a colleague": Nearly half (48%) said "yes," and 25% said "maybe." But a far smaller percentage confess to going to work with the flu — only 30% admitted to doing it.

Doctors agree that almost everyone should get the flu shot, but opinions were mixed on whether schools and businesses should require it. Among the people we surveyed, 66% agreed that flu shots should be mandatory for public school students; but only 55% felt that employers should require the same.

Unsurprisingly, people who have encountered a nasty virus at work were much more likely to think the shot should be mandatory. As much as 63% of people who said they've gotten sick from their co-workers said it should be required, but just 48% of people who had not gotten sick from a co-worker agreed.

Methodology

ValuePenguin commissioned Qualtrics to conduct an online survey of 1,226 Americans, with the sample base proportioned to represent the general population. The survey was fielded October 15-17, 2019.