A Map of Racial and Ethnic Disparities in Influenza Vaccine Uptake in the Medicare Fee-for-Service Program

Adv Ther. 2020 May;37(5):2224-2235. doi: 10.1007/s12325-020-01324-y. Epub 2020 Apr 9.

Abstract

Introduction: Despite improved understanding of the risks of influenza and better vaccines for older patients, influenza vaccination rates remain subpar, including in high-risk groups such as older adults, and demonstrate significant racial and ethnic disparities.

Methods: This study considers demographic, clinical, and geographic correlates of influenza vaccination among Medicare Fee-for-Service (FFS) beneficiaries in 2015-2016 and maps the data on a geographic information system (GIS) at the zip code level.

Results: Analyses confirm that only half of the senior beneficiaries evidenced a claim for receiving an inactivated influenza vaccine (IIV), with significant disparities observed among black, Hispanic, rural, and poorer beneficiaries. More extensive disparities were observed for the high-dose (HD) vaccine, with its added protection for older populations and confirmed economic benefit. Most white beneficiaries received HD; no non-white subgroup did so. Mapping of the data confirmed subpar vaccination in vulnerable populations with wide variations at the zip code level.

Conclusion: Urgent and targeted efforts are needed to equitably increase IIV rates, thus protecting the most vulnerable populations from the negative health impact of influenza as well as the tax-paying public from the Medicare costs from failing to do so.

Keywords: Disparities; Geomapping; Infectious diseases; Influenza vaccine; Medicare.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Black or African American / psychology
  • Black or African American / statistics & numerical data
  • Ethnicity / psychology
  • Ethnicity / statistics & numerical data
  • Fee-for-Service Plans / statistics & numerical data
  • Female
  • Healthcare Disparities / statistics & numerical data*
  • Hispanic or Latino / psychology
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Influenza Vaccines / administration & dosage*
  • Influenza, Human / epidemiology
  • Influenza, Human / prevention & control*
  • Male
  • Medicare / statistics & numerical data
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • United States / epidemiology
  • Vaccination / psychology*
  • Vaccination / statistics & numerical data*
  • White People / psychology
  • White People / statistics & numerical data

Substances

  • Influenza Vaccines