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

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.

Mental Health Policy in the Era of COVID-19

“…Although mental health care delivery may be bolstered by increased funding and a larger and more empowered workforce, policies should also consider how long-entrenched disparities can be addressed with expansion of programs, coordination across social services agencies (e.g., housing, employment, schools, and criminal justice system), and targeted outreach to vulnerable populations (e.g., homeless, immigrant, and incarcerated) to prevent viral spread and facilitate access to care from first episode through recovery. Furthermore, given existing disparities in preventive health care, such as influenza vaccinations, among people with serious mental illness (28,29), a concerted effort will be needed to ensure equitable access to an eventual COVID-19 vaccine.…”

Social Determinants Associated with COVID-19 Mortality in the United States

“…As elderly populations and groups with comorbidities are more vunerable COVID -19 [8], the observed relationship between between vaccination rates and COVID-19 may represent the underlying relation-ship between at-risk groups and COVID-19. However, as there are severe geographical, racial, and socioeconomic disparities in influenza vaccination rates [48], future analysis of vaccination and COVID-19 mortality is needed to reveal more about this complex relationship.…”

Racial and geographic disparities in influenza vaccination in the U.S. among individuals with atherosclerotic cardiovascular disease: Renewed importance in the setting of COVID-19

“…influenza and SARS-CoV-2 which may result in increased hospitalizations that could overwhelm the healthcare infrastructure. While clinicians and public health officials stress the importance of receiving annual influenza vaccinations, vaccination rates remain low in the general population and may differ by race/ethnicity [ 4 , 5 ]. These disparities can also be geographic in nature as vaccine hesitancy has been shown to cluster by geography as well [5] .…”

“…While clinicians and public health officials stress the importance of receiving annual influenza vaccinations, vaccination rates remain low in the general population and may differ by race/ethnicity [ 4 , 5 ]. These disparities can also be geographic in nature as vaccine hesitancy has been shown to cluster by geography as well [5] . Receiving an influenza vaccine is particularly critical among patients with cardiovascular risk factors and those with atherosclerotic cardiovascular disease (ASCVD) [6] .…”