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Factors associated with vaccination of medicare beneficiaries in five U.S. communities: Results from the racial and ethnic adult disparities in immunization initiative survey, 2003.
J Am Geriatr Soc. 2006 Feb; 54(2):303-10.JA

Abstract

OBJECTIVES

To examine vaccination in seniors in the five U.S. communities of the Racial and Ethnic Adult Disparities in Immunization Initiative.

DESIGN

Cross-sectional telephone survey in spring 2003 using stratified sampling by ZIP code and race/ethnicity.

SETTING

New York, Texas, Wisconsin, Illinois, and Mississippi.

PARTICIPANTS

Four thousand five hundred seventy-seven Medicare beneficiaries.

MEASUREMENTS

Outcomes were pneumococcal vaccination ever and influenza vaccination in 2002/03 and were determined according to race/ethnicity, awareness of vaccination, and provider recommendation. Survey questions also asked about future plans for vaccination, whether respondents believed they had become sick from prior influenza vaccination, and whether unvaccinated respondents would be vaccinated if a health professional recommended it.

RESULTS

Pneumococcal vaccination coverage was 70.3% for whites, 40.8% for blacks, and 53.2% for Hispanics, and the proportion reporting provider recommendation for vaccination differed significantly according to race/ethnicity. In multivariate regression, provider recommendation (risk ratio (RR) = 2.32, 95% confidence intervals (CI) = 2.10-2.57) and awareness of vaccination (RR = 1.60, 95% CI = 1.40-1.82) were associated with greater pneumococcal vaccination. Influenza vaccination coverage was 76.2% for whites, 50.7% for blacks, and 65.7% for Hispanics. A little more than half of respondents reported provider recommendation for influenza vaccination, with no differences according to race/ethnicity. Provider recommendation was associated with influenza vaccination (RR = 1.31, 95% CI = 1.25-1.38). More blacks and Hispanics believed they had become sick from prior influenza vaccination than whites, and this belief was associated with lower vaccination rates.

CONCLUSION

This survey details vaccination patterns in an ethnically and geographically diverse sample of seniors and identifies some differences between blacks, Hispanics, and whites that may contribute to disparities in vaccination coverage. Survey findings highlight the importance of provider vaccination recommendations.

Authors+Show Affiliations

Health Services Research and Evaluation Branch, Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. cwinston@cdc.govNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

16460383

Citation

Winston, Carla A., et al. "Factors Associated With Vaccination of Medicare Beneficiaries in Five U.S. Communities: Results From the Racial and Ethnic Adult Disparities in Immunization Initiative Survey, 2003." Journal of the American Geriatrics Society, vol. 54, no. 2, 2006, pp. 303-10.
Winston CA, Wortley PM, Lees KA. Factors associated with vaccination of medicare beneficiaries in five U.S. communities: Results from the racial and ethnic adult disparities in immunization initiative survey, 2003. J Am Geriatr Soc. 2006;54(2):303-10.
Winston, C. A., Wortley, P. M., & Lees, K. A. (2006). Factors associated with vaccination of medicare beneficiaries in five U.S. communities: Results from the racial and ethnic adult disparities in immunization initiative survey, 2003. Journal of the American Geriatrics Society, 54(2), 303-10.
Winston CA, Wortley PM, Lees KA. Factors Associated With Vaccination of Medicare Beneficiaries in Five U.S. Communities: Results From the Racial and Ethnic Adult Disparities in Immunization Initiative Survey, 2003. J Am Geriatr Soc. 2006;54(2):303-10. PubMed PMID: 16460383.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors associated with vaccination of medicare beneficiaries in five U.S. communities: Results from the racial and ethnic adult disparities in immunization initiative survey, 2003. AU - Winston,Carla A, AU - Wortley,Pascale M, AU - Lees,Karen A, PY - 2006/2/8/pubmed PY - 2006/3/24/medline PY - 2006/2/8/entrez SP - 303 EP - 10 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 54 IS - 2 N2 - OBJECTIVES: To examine vaccination in seniors in the five U.S. communities of the Racial and Ethnic Adult Disparities in Immunization Initiative. DESIGN: Cross-sectional telephone survey in spring 2003 using stratified sampling by ZIP code and race/ethnicity. SETTING: New York, Texas, Wisconsin, Illinois, and Mississippi. PARTICIPANTS: Four thousand five hundred seventy-seven Medicare beneficiaries. MEASUREMENTS: Outcomes were pneumococcal vaccination ever and influenza vaccination in 2002/03 and were determined according to race/ethnicity, awareness of vaccination, and provider recommendation. Survey questions also asked about future plans for vaccination, whether respondents believed they had become sick from prior influenza vaccination, and whether unvaccinated respondents would be vaccinated if a health professional recommended it. RESULTS: Pneumococcal vaccination coverage was 70.3% for whites, 40.8% for blacks, and 53.2% for Hispanics, and the proportion reporting provider recommendation for vaccination differed significantly according to race/ethnicity. In multivariate regression, provider recommendation (risk ratio (RR) = 2.32, 95% confidence intervals (CI) = 2.10-2.57) and awareness of vaccination (RR = 1.60, 95% CI = 1.40-1.82) were associated with greater pneumococcal vaccination. Influenza vaccination coverage was 76.2% for whites, 50.7% for blacks, and 65.7% for Hispanics. A little more than half of respondents reported provider recommendation for influenza vaccination, with no differences according to race/ethnicity. Provider recommendation was associated with influenza vaccination (RR = 1.31, 95% CI = 1.25-1.38). More blacks and Hispanics believed they had become sick from prior influenza vaccination than whites, and this belief was associated with lower vaccination rates. CONCLUSION: This survey details vaccination patterns in an ethnically and geographically diverse sample of seniors and identifies some differences between blacks, Hispanics, and whites that may contribute to disparities in vaccination coverage. Survey findings highlight the importance of provider vaccination recommendations. SN - 0002-8614 UR - https://www.unboundmedicine.com/medline/citation/16460383/Factors_associated_with_vaccination_of_medicare_beneficiaries_in_five_U_S__communities:_Results_from_the_racial_and_ethnic_adult_disparities_in_immunization_initiative_survey_2003_ L2 - https://doi.org/10.1111/j.1532-5415.2005.00585.x DB - PRIME DP - Unbound Medicine ER -