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Influenza vaccine supply and racial/ethnic disparities in vaccination among the elderly.
Am J Prev Med. 2011 Jan; 40(1):1-10.AJ

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=8.23-8.99 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% (W-AA 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.

Authors+Show Affiliations

Department of Community and Preventive Medicine, University of Rochester, New York, USA. Byung-Kwang_Yoo@urmc.rochester.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

21146761

Citation

Yoo, Byung-Kwang, et al. "Influenza Vaccine Supply and Racial/ethnic Disparities in Vaccination Among the Elderly." American Journal of Preventive Medicine, vol. 40, no. 1, 2011, pp. 1-10.
Yoo BK, Kasajima M, Phelps CE, et al. Influenza vaccine supply and racial/ethnic disparities in vaccination among the elderly. Am J Prev Med. 2011;40(1):1-10.
Yoo, B. K., Kasajima, M., Phelps, C. E., Fiscella, K., Bennett, N. M., & Szilagyi, P. G. (2011). Influenza vaccine supply and racial/ethnic disparities in vaccination among the elderly. American Journal of Preventive Medicine, 40(1), 1-10. https://doi.org/10.1016/j.amepre.2010.09.028
Yoo BK, et al. Influenza Vaccine Supply and Racial/ethnic Disparities in Vaccination Among the Elderly. Am J Prev Med. 2011;40(1):1-10. PubMed PMID: 21146761.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influenza vaccine supply and racial/ethnic disparities in vaccination among the elderly. AU - Yoo,Byung-Kwang, AU - Kasajima,Megumi, AU - Phelps,Charles E, AU - Fiscella,Kevin, AU - Bennett,Nancy M, AU - Szilagyi,Peter G, PY - 2009/12/04/received PY - 2010/06/01/revised PY - 2010/09/03/accepted PY - 2010/12/15/entrez PY - 2010/12/15/pubmed PY - 2011/3/26/medline SP - 1 EP - 10 JF - American journal of preventive medicine JO - Am J Prev Med VL - 40 IS - 1 N2 - 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=8.23-8.99 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% (W-AA 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. SN - 1873-2607 UR - https://www.unboundmedicine.com/medline/citation/21146761/Influenza_vaccine_supply_and_racial/ethnic_disparities_in_vaccination_among_the_elderly_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-3797(10)00553-2 DB - PRIME DP - Unbound Medicine ER -