Giuseppe
Emeritus
Influenza Vaccine Supply and Racial/Ethnic Disparities in Vaccination Among the Elderly (Am J Prev Med., abstract, edited)
[Source: American Journal of Preventive Medicine, Volume 40, Issue 1 , Pages 1-10, January 2011, full text: <cite cite="http://www.ajpm-online.net/article/PIIS0749379710005532/abstract?rss=yes">Influenza Vaccine Supply and Racial/Ethnic Disparities in Vaccination Among the Elderly</cite>. Abstract, edited.]
Influenza Vaccine Supply and Racial/Ethnic Disparities in Vaccination Among the Elderly
* Byung-Kwang Yoo, MD, PhD
Affiliations:
o Department of Community and Preventive Medicine, University of Rochester, Rochester, New York
o Corresponding Author Information: Address correspondence to: Byung-Kwang Yoo, MD, PhD, 601 Elmwood Avenue, Box 644, Rochester NY 14642 email address
* Megumi Kasajima, BS
Affiliations:
o Department of Community and Preventive Medicine, University of Rochester, Rochester, New York
* , Charles E. Phelps, PhD
Affiliations:
o Provost's Office, University of Rochester, Rochester, New York
*Kevin Fiscella, MD, MPH
Affiliations:
o Department of Family Medicine, University of Rochester, Rochester, New York
* Nancy M. Bennett, MD, MS
Affiliations:
o Department of Medicine, University of Rochester, Rochester, New York
* Peter G. Szilagyi, MD, MPH
Affiliations:
o Department of Pediatrics, University of Rochester, Rochester, New York
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.
PII: S0749-3797(10)00553-2
doi:10.1016/j.amepre.2010.09.028
? 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
-
------
[Source: American Journal of Preventive Medicine, Volume 40, Issue 1 , Pages 1-10, January 2011, full text: <cite cite="http://www.ajpm-online.net/article/PIIS0749379710005532/abstract?rss=yes">Influenza Vaccine Supply and Racial/Ethnic Disparities in Vaccination Among the Elderly</cite>. Abstract, edited.]
Influenza Vaccine Supply and Racial/Ethnic Disparities in Vaccination Among the Elderly
* Byung-Kwang Yoo, MD, PhD
Affiliations:
o Department of Community and Preventive Medicine, University of Rochester, Rochester, New York
o Corresponding Author Information: Address correspondence to: Byung-Kwang Yoo, MD, PhD, 601 Elmwood Avenue, Box 644, Rochester NY 14642 email address
* Megumi Kasajima, BS
Affiliations:
o Department of Community and Preventive Medicine, University of Rochester, Rochester, New York
* , Charles E. Phelps, PhD
Affiliations:
o Provost's Office, University of Rochester, Rochester, New York
*Kevin Fiscella, MD, MPH
Affiliations:
o Department of Family Medicine, University of Rochester, Rochester, New York
* Nancy M. Bennett, MD, MS
Affiliations:
o Department of Medicine, University of Rochester, Rochester, New York
* Peter G. Szilagyi, MD, MPH
Affiliations:
o Department of Pediatrics, University of Rochester, Rochester, New York
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.
PII: S0749-3797(10)00553-2
doi:10.1016/j.amepre.2010.09.028
? 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
-
------