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J Am Geriatr Soc . Influenza and pneumococcal vaccination delivery in older Hispanic populations in the United States

tetano

Editor, Senior Moderator
J Am Geriatr Soc


. 2021 Dec 2.
doi: 10.1111/jgs.17589. Online ahead of print.
Influenza and pneumococcal vaccination delivery in older Hispanic populations in the United States


John Heintzman[SUP] 1 2 [/SUP], Jun Hwang[SUP] 1 [/SUP], Ana R Quiñones[SUP] 1 [/SUP], Cirila Estela Vasquez Guzman[SUP] 1 [/SUP], Steffani R Bailey[SUP] 1 [/SUP], Jennifer Lucas[SUP] 1 [/SUP], Sophia Giebultowicz[SUP] 2 [/SUP], Brian Chan[SUP] 2 3 [/SUP], Miguel Marino[SUP] 1 [/SUP]



Affiliations

Abstract

Introduction: National reports suggest that Hispanic patients may underutilize influenza and pneumococcal vaccination, although studies sometimes conflict on this point. A clearer picture of adult immunization utilization in older Hispanic patients is necessary to ensure equity in adult vaccinations.
Methods: Using electronic health records from 648 community health centers (CHCs) across 21 states, we compared English-preferring Hispanic patients, Spanish-preferring Hispanic patients, and Non-Hispanic White (NHW) adults aged ≥50 years across five outcomes between 2012-2017: (1) Odds of ever receiving pneumococcal vaccination after age 65, (2) Odds of ever receiving ≥2 pneumococcal vaccinations for those ≥65, (3) odds of vaccination between the ages of 50 and 64 for those with diabetes or heart disease, (4) odds of influenza vaccine, and (5) annual rate of influenza vaccination.
Results: Of our total study sample (N = 143,869), 85,562 were age 50-64 during the entire study period, and 65,977 were ≥65 at some point during the study period. In patients aged 50-64, Spanish-preferring Hispanic patients were more likely to have ever had an influenza vaccination (covariate-adjusted odds ratio [aOR] = 1.33, 95% CI = 1.29-1.37), had higher rates of annual influenza vaccination (covariate-adjusted rate ratio [aRR] = 1.41, 95% CI = 1.38-1.44), and higher odds of pneumococcal vaccination (aOR = 1.87, 95% CI = 1.76-1.98) than NHW patients. These findings were similar in Spanish-preferring Hispanic patients ≥65. English-preferring Hispanics ≥65 were less likely than NHW patients to ever have an influenza vaccination (aOR = 0.91, 95% CI = 0.85-0.98) and to have ever received at least one (aOR = 0.92, 95% CI = 0.86-0.99) or two (aOR = 0.86, 95% CI = 0.77-0.95) pneumococcal vaccine doses.
Conclusions: In a multistate CHC network, Spanish-preferring Hispanic patients were more likely to receive influenza and pneumococcal vaccinations than NHW patients; older English-preferring Hispanic patients were often less likely than NHW patients to receive these vaccinations. In vaccine initiatives, English-preferring Hispanic patients may be at higher risk of vaccination inequity.

Keywords: Hispanic influenza vaccination; electronic health records; pneumococcal vaccination.
 
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