Influenza vaccine supply and racial/ethnic disparities in vaccination among the elderly

Byung Kwang Yoo, Megumi Kasajima, Charles E. Phelps, Kevin Fiscella, Nancy M. Bennett, Peter G. Szilagyi

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: The impact of vaccine shortages on disparities in influenza vaccination is uncertain. Purpose: The objective of this research was to examine the association between influenza vaccine supply and racial/ethnic disparities in vaccination rates among elderly Medicare beneficiaries. Methods: Cross-sectional multivariable logistic regression analyses were performed in 2010 to examine whether racial/ethnic disparities in vaccination rates changed across two consecutive seasons: from (Period 1) 2000-2001 and 2001-2002 seasons through (Period 4) 2003-2004 and 2004-2005 seasons. Self-reported receipt of influenza vaccine across consecutive years was examined among community-dwelling non-Hispanic African-American (AA); non-Hispanic white (W); English-speaking Hispanic (EH); and Spanish-speaking Hispanic (SH) elderly enrolled in the Medicare Current Beneficiary Survey (unweighted n=2306-2504, weighted n=8.238.99 million for Periods 1 through 4). Results: During Periods 1 and 2, when vaccine supply increased nationally, adjusted racial/ethnic disparities in the influenza vaccination rate decreased by 1.8%7.4% (WAA disparity); 4.5%6.6% (W-EH disparity); and 6.6%11% (W-SH disparity) (all p<0.001). During Period 4, when vaccine supply declined, adjusted disparities in vaccination rates increased by 2.3% (W-AA disparity) and 6.1% (W-EH disparity) but decreased by 6.6% (W-SH disparity) probably due to a "floor effect" (constant low rates among SH; all p<0.001). Conclusions: Improved vaccine supply was generally associated with reduced racial/ethnic disparities in influenza vaccination rates, whereas worse supply was associated with increased disparities. To avoid future widening of racial health disparities, policy options include stabilizing the vaccine supply and preferential delivery of vaccines to safety-net providers serving AA and Hispanic populations during a shortage.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalAmerican Journal of Preventive Medicine
Volume40
Issue number1
DOIs
StatePublished - Jan 2011
Externally publishedYes

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Influenza Vaccines
Hispanic Americans
Vaccination
Vaccines
African Americans
Human Influenza
Medicare
Safety-net Providers
Independent Living
Health Policy
Logistic Models
Regression Analysis
Research

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology

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Influenza vaccine supply and racial/ethnic disparities in vaccination among the elderly. / Yoo, Byung Kwang; Kasajima, Megumi; Phelps, Charles E.; Fiscella, Kevin; Bennett, Nancy M.; Szilagyi, Peter G.

In: American Journal of Preventive Medicine, Vol. 40, No. 1, 01.2011, p. 1-10.

Research output: Contribution to journalArticle

Yoo, Byung Kwang ; Kasajima, Megumi ; Phelps, Charles E. ; Fiscella, Kevin ; Bennett, Nancy M. ; Szilagyi, Peter G. / Influenza vaccine supply and racial/ethnic disparities in vaccination among the elderly. In: American Journal of Preventive Medicine. 2011 ; Vol. 40, No. 1. pp. 1-10.
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abstract = "Background: The impact of vaccine shortages on disparities in influenza vaccination is uncertain. Purpose: The objective of this research was to examine the association between influenza vaccine supply and racial/ethnic disparities in vaccination rates among elderly Medicare beneficiaries. Methods: Cross-sectional multivariable logistic regression analyses were performed in 2010 to examine whether racial/ethnic disparities in vaccination rates changed across two consecutive seasons: from (Period 1) 2000-2001 and 2001-2002 seasons through (Period 4) 2003-2004 and 2004-2005 seasons. Self-reported receipt of influenza vaccine across consecutive years was examined among community-dwelling non-Hispanic African-American (AA); non-Hispanic white (W); English-speaking Hispanic (EH); and Spanish-speaking Hispanic (SH) elderly enrolled in the Medicare Current Beneficiary Survey (unweighted n=2306-2504, weighted n=8.238.99 million for Periods 1 through 4). Results: During Periods 1 and 2, when vaccine supply increased nationally, adjusted racial/ethnic disparities in the influenza vaccination rate decreased by 1.8{\%}7.4{\%} (WAA disparity); 4.5{\%}6.6{\%} (W-EH disparity); and 6.6{\%}11{\%} (W-SH disparity) (all p<0.001). During Period 4, when vaccine supply declined, adjusted disparities in vaccination rates increased by 2.3{\%} (W-AA disparity) and 6.1{\%} (W-EH disparity) but decreased by 6.6{\%} (W-SH disparity) probably due to a {"}floor effect{"} (constant low rates among SH; all p<0.001). Conclusions: Improved vaccine supply was generally associated with reduced racial/ethnic disparities in influenza vaccination rates, whereas worse supply was associated with increased disparities. To avoid future widening of racial health disparities, policy options include stabilizing the vaccine supply and preferential delivery of vaccines to safety-net providers serving AA and Hispanic populations during a shortage.",
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AB - Background: The impact of vaccine shortages on disparities in influenza vaccination is uncertain. Purpose: The objective of this research was to examine the association between influenza vaccine supply and racial/ethnic disparities in vaccination rates among elderly Medicare beneficiaries. Methods: Cross-sectional multivariable logistic regression analyses were performed in 2010 to examine whether racial/ethnic disparities in vaccination rates changed across two consecutive seasons: from (Period 1) 2000-2001 and 2001-2002 seasons through (Period 4) 2003-2004 and 2004-2005 seasons. Self-reported receipt of influenza vaccine across consecutive years was examined among community-dwelling non-Hispanic African-American (AA); non-Hispanic white (W); English-speaking Hispanic (EH); and Spanish-speaking Hispanic (SH) elderly enrolled in the Medicare Current Beneficiary Survey (unweighted n=2306-2504, weighted n=8.238.99 million for Periods 1 through 4). Results: During Periods 1 and 2, when vaccine supply increased nationally, adjusted racial/ethnic disparities in the influenza vaccination rate decreased by 1.8%7.4% (WAA disparity); 4.5%6.6% (W-EH disparity); and 6.6%11% (W-SH disparity) (all p<0.001). During Period 4, when vaccine supply declined, adjusted disparities in vaccination rates increased by 2.3% (W-AA disparity) and 6.1% (W-EH disparity) but decreased by 6.6% (W-SH disparity) probably due to a "floor effect" (constant low rates among SH; all p<0.001). Conclusions: Improved vaccine supply was generally associated with reduced racial/ethnic disparities in influenza vaccination rates, whereas worse supply was associated with increased disparities. To avoid future widening of racial health disparities, policy options include stabilizing the vaccine supply and preferential delivery of vaccines to safety-net providers serving AA and Hispanic populations during a shortage.

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