Health Care

Obamacare plans might improve Florida’s low rates of flu vaccination

Libby Michaelson, 66, from Tamarac, reacts while receiving a flu shot several years ago at the Broward Mall in Plantation.
Libby Michaelson, 66, from Tamarac, reacts while receiving a flu shot several years ago at the Broward Mall in Plantation. MIAMI HERALD FILE

Floridians receive influenza vaccinations at rates below the national average, but that might change as more people sign up for healthcare insurance under the Affordable Care Act, consumer advocates and health experts say.

Flu shots are free under ACA plans, as long as consumers stay in-network.

“We have already seen an increase in the use of many preventive services, including flu vaccinations, that plans must now offer — at no cost to consumers — as a result of the ACA,” said Greg Mellowe, policy director of Florida CHAIN, a consumer group.

As a worse-than-expected flu season approaches, it’s important for people to get the vaccine, health officials say.

Florida trails other states in vaccinating key groups such as children, high-risk adults and the elderly, according to data collected by the Centers for Disease Control and Prevention. During the 2013-2014 flu season, Florida vaccinated 37 percent of “high-risk” adults between the ages of 18 and 64, the lowest rate in the nation. Adults at high risk include those with asthma, diabetes, cancer and other chronic conditions.

About 59 percent of Florida residents over 65 received a vaccine, putting Florida at No. 45 out of 50 states. Meanwhile, 63.6 percent of children between 6 months and 4 years old were vaccinated, meaning the state falls at 42nd in the nation.

Florida was about seven points below the national average for both categories.

The state also fell below national averages for vaccinating Hispanics and African-Americans by 11 points each.

Other big states are vaccinating more of their residents than Florida, including New York, which has a population of similar size.

At the Florida Department of Health, improving flu shot rates “is a priority,” said spokesman Nathan Dunn. “Outreach activities have been ongoing at the state and county level since launching the flu vaccination campaign in September,” he said.

About 90,000 Florida children in more than 30 school districts have been vaccinated this year through the statewide “Healthy Schools” program, according to Dunn.

Healthcare advocates are optimistic that Florida will increase its vaccination rates as more people take advantage of the health law.

“We’re going to see those numbers begin to improve, especially given how many folks enrolled in Florida last time around,” said Nick Duran, state director for Enroll America, a nonprofit that advocates for people to sign up for coverage under the health law.

“That’s something we’re telling people when they sign up: ‘Look, you can go get your flu shot today. It’s free,’” Duran said.

About 762,000 Floridians had ACA plans as of June, according to the Florida Office of Insurance Regulation.

Robert Prieto, a CVS pharmacist in Miami Lakes, said he has noticed a change since his customers started signing up for Obamacare in 2013.

“I have patients who’ve had no insurance in the past — people who paid cash if they needed a prescription — and they come in and tell me they’ve signed up for the ACA,” said Prieto, who’s worked at the same pharmacy for 21 years. “And I say they can get a flu shot now and they say they can’t afford it and I tell them it’s free.”

Prieto said some of his patients worry that the vaccine might give them the flu virus, which isn’t true. Misinformation can put others at risk, he said.

“You may have kids, you may have elderly parents and [if you don’t get vaccinated] then you can spread it to your household and before you know it everyone is sick,” Prieto said.

It’s not clear why so few Floridians choose to get a flu shot compared to other states, but it could be as simple as the weather, said Ted Ross, an influenza researcher and program director for the Vaccine and Gene Therapy Institute of Florida in Port St. Lucie.

“People associate influenza with the winter months but the flu circulates year-round,” Ross said. “It’s not cold here and that may lead some people to think the flu isn’t as great of a threat.”

Robert Brooks, the secretary of the Florida DOH between 1999 and 2001, said the state might not be devoting enough resources to advertising the vaccine.

“I think it has more to do with a lack of marketing exposure than something inherent to Florida’s demographic,” he said.

And there are more complicated factors at play, too.

Florida Medicaid for many years reimbursed pediatricians at well under CDC-recommended rates for administering vaccines to children, said Louis St. Petery, executive vice president of the Florida Chapter of the American Academy of Pediatrics.

The AAP’s Florida chapter filed a lawsuit against the state in 2005 alleging that children on Medicaid in Florida were not receiving essential medical and dental benefits, in part because the state reimbursed pediatricians at low rates. A federal judge is preparing to issue his final ruling on the long-running case.

Seasonal flu can be especially dangerous to children under 5. Ninety percent of children who died from influenza last year did not receive a flu shot, according to the CDC.

This year’s flu season may be worse than usual.

Each season includes several different subtypes of flu virus. Vaccine designers must predict which strains they expect to spread the most.

A new, more virulent form is spreading this year, which federal health officials did not expect, and the vaccine might not provide full protection against it.

Lakisha Thomas, an epidemiologist with the health department in Miami-Dade County, said the flu threat countywide was “slightly elevated” compared to this time last year.

Federal and local health officials are urging people to get their flu shots before the season hits its peak in January and February.

“The vaccine will still protect you to some extent,” said Ross, the flu researcher. “It will lessen your symptoms if you do get exposed, it will lessen transmission to others, and it will lessen mortality rates for children and the elderly.”

“If you don’t get the vaccine, you’ll be completely vulnerable to the flu,” he said.

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This article was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

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