Influenza Vaccine Supply and Racial/Ethnic Disparities in Vaccination Among the Elderly
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 Cro...
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| Veröffentlicht in: | American journal of preventive medicine 2011, Vol.40 (1), p.1-10 |
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| creator | Yoo, Byung-Kwang, MD, PhD Kasajima, Megumi, BS Phelps, Charles E., PhD Fiscella, Kevin, MD, MPH Bennett, Nancy M., MD, MS Szilagyi, Peter G., MD, MPH |
| description | 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 |
| doi_str_mv | 10.1016/j.amepre.2010.09.028 |
| format | Article |
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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.</description><identifier>ISSN: 0749-3797</identifier><identifier>EISSN: 1873-2607</identifier><identifier>DOI: 10.1016/j.amepre.2010.09.028</identifier><identifier>PMID: 21146761</identifier><identifier>CODEN: AJPMEA</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject><![CDATA[African Americans - statistics & numerical data ; Aged ; Cross-Sectional Studies ; Ethnic differences ; Ethnic groups ; European Continental Ancestry Group - statistics & numerical data ; Female ; Health surveys ; Healthcare Disparities - ethnology ; Hispanic Americans - statistics & numerical data ; Hispanic people ; Humans ; Immunization ; Influenza ; Influenza Vaccines - administration & dosage ; Influenza Vaccines - supply & distribution ; Influenza, Human - ethnology ; Influenza, Human - prevention & control ; Internal Medicine ; Logistic Models ; Male ; Medicare ; Minorities ; Multivariate Analysis ; Population policy ; Racial differences ; United States ; Vaccination and vaccines ; Vaccines]]></subject><ispartof>American journal of preventive medicine, 2011, Vol.40 (1), p.1-10</ispartof><rights>American Journal of Preventive Medicine</rights><rights>2011 American Journal of Preventive Medicine</rights><rights>Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c480t-5d0818ced73d3990f57cf5bfe5fc4bbb346327c5b168fa77cb3d4a9a6a2626813</citedby><cites>FETCH-LOGICAL-c480t-5d0818ced73d3990f57cf5bfe5fc4bbb346327c5b168fa77cb3d4a9a6a2626813</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0749379710005532$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,4009,27844,27902,27903,27904,30979,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21146761$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yoo, Byung-Kwang, MD, PhD</creatorcontrib><creatorcontrib>Kasajima, Megumi, BS</creatorcontrib><creatorcontrib>Phelps, Charles E., PhD</creatorcontrib><creatorcontrib>Fiscella, Kevin, MD, MPH</creatorcontrib><creatorcontrib>Bennett, Nancy M., MD, MS</creatorcontrib><creatorcontrib>Szilagyi, Peter G., MD, MPH</creatorcontrib><title>Influenza Vaccine Supply and Racial/Ethnic Disparities in Vaccination Among the Elderly</title><title>American journal of preventive medicine</title><addtitle>Am J Prev Med</addtitle><description>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.</description><subject>African Americans - statistics & numerical data</subject><subject>Aged</subject><subject>Cross-Sectional Studies</subject><subject>Ethnic differences</subject><subject>Ethnic groups</subject><subject>European Continental Ancestry Group - statistics & numerical data</subject><subject>Female</subject><subject>Health surveys</subject><subject>Healthcare Disparities - ethnology</subject><subject>Hispanic Americans - statistics & numerical data</subject><subject>Hispanic people</subject><subject>Humans</subject><subject>Immunization</subject><subject>Influenza</subject><subject>Influenza Vaccines - administration & dosage</subject><subject>Influenza Vaccines - supply & distribution</subject><subject>Influenza, Human - ethnology</subject><subject>Influenza, Human - prevention & control</subject><subject>Internal Medicine</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medicare</subject><subject>Minorities</subject><subject>Multivariate Analysis</subject><subject>Population policy</subject><subject>Racial differences</subject><subject>United States</subject><subject>Vaccination and vaccines</subject><subject>Vaccines</subject><issn>0749-3797</issn><issn>1873-2607</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>7TQ</sourceid><recordid>eNqNkl1rFDEUhoModq3-A5HceTXbfMzk40Yo7aqFQqGtehkymTM2ayYzJjPC9tebZVcvvKlXgfCcc-B9XoTeUrKmhIqz7doOMCVYM1K-iF4Tpp6hFVWSV0wQ-RytiKx1xaWWJ-hVzltCiFRUv0QnjNJaSEFX6NtV7MMC8dHir9Y5HwHfLdMUdtjGDt9a520428wP0Tt86fNkk589ZOzjkbezHyM-H8b4Hc8PgDehgxR2r9GL3oYMb47vKfrycXN_8bm6vvl0dXF-XblakblqOqKoctBJ3nGtSd9I1zdtD03v6rZteS04k65pqVC9ldK1vKuttsIywYSi_BS9P-yd0vhzgTybwWcHIdgI45KNakTZy6j-D5IzoimVT5MlPs10rQpZH0iXxpwT9GZKfrBpZygxe0tmaw6WzN6SIdoUS2Xs3fHA0g7Q_R36o6UAHw4AlOh-eUgmOw-x5OQTuNl0o3_qwr8LXPDFoQ0_YAd5Oy4pFi2GmswMMXf7puyLQktHmhIE_w2Mr7lR</recordid><startdate>2011</startdate><enddate>2011</enddate><creator>Yoo, Byung-Kwang, MD, PhD</creator><creator>Kasajima, Megumi, BS</creator><creator>Phelps, Charles E., PhD</creator><creator>Fiscella, Kevin, MD, MPH</creator><creator>Bennett, Nancy M., MD, MS</creator><creator>Szilagyi, Peter G., MD, MPH</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QJ</scope><scope>7TQ</scope><scope>DHY</scope><scope>DON</scope></search><sort><creationdate>2011</creationdate><title>Influenza Vaccine Supply and Racial/Ethnic Disparities in Vaccination Among the Elderly</title><author>Yoo, Byung-Kwang, MD, PhD ; Kasajima, Megumi, BS ; Phelps, Charles E., PhD ; Fiscella, Kevin, MD, MPH ; Bennett, Nancy M., MD, MS ; Szilagyi, Peter G., MD, MPH</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c480t-5d0818ced73d3990f57cf5bfe5fc4bbb346327c5b168fa77cb3d4a9a6a2626813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>African Americans - statistics & numerical data</topic><topic>Aged</topic><topic>Cross-Sectional Studies</topic><topic>Ethnic differences</topic><topic>Ethnic groups</topic><topic>European Continental Ancestry Group - statistics & numerical data</topic><topic>Female</topic><topic>Health surveys</topic><topic>Healthcare Disparities - ethnology</topic><topic>Hispanic Americans - statistics & numerical data</topic><topic>Hispanic people</topic><topic>Humans</topic><topic>Immunization</topic><topic>Influenza</topic><topic>Influenza Vaccines - administration & dosage</topic><topic>Influenza Vaccines - supply & distribution</topic><topic>Influenza, Human - ethnology</topic><topic>Influenza, Human - prevention & control</topic><topic>Internal Medicine</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medicare</topic><topic>Minorities</topic><topic>Multivariate Analysis</topic><topic>Population policy</topic><topic>Racial differences</topic><topic>United States</topic><topic>Vaccination and vaccines</topic><topic>Vaccines</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoo, Byung-Kwang, MD, PhD</creatorcontrib><creatorcontrib>Kasajima, Megumi, BS</creatorcontrib><creatorcontrib>Phelps, Charles E., PhD</creatorcontrib><creatorcontrib>Fiscella, Kevin, MD, MPH</creatorcontrib><creatorcontrib>Bennett, Nancy M., MD, MS</creatorcontrib><creatorcontrib>Szilagyi, Peter G., MD, MPH</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>PAIS Index</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><jtitle>American journal of preventive medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoo, Byung-Kwang, MD, PhD</au><au>Kasajima, Megumi, BS</au><au>Phelps, Charles E., PhD</au><au>Fiscella, Kevin, MD, MPH</au><au>Bennett, Nancy M., MD, MS</au><au>Szilagyi, Peter G., MD, MPH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influenza Vaccine Supply and Racial/Ethnic Disparities in Vaccination Among the Elderly</atitle><jtitle>American journal of preventive medicine</jtitle><addtitle>Am J Prev Med</addtitle><date>2011</date><risdate>2011</risdate><volume>40</volume><issue>1</issue><spage>1</spage><epage>10</epage><pages>1-10</pages><issn>0749-3797</issn><eissn>1873-2607</eissn><coden>AJPMEA</coden><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.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>21146761</pmid><doi>10.1016/j.amepre.2010.09.028</doi><tpages>10</tpages></addata></record> |
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| subjects | African Americans - statistics & numerical data Aged Cross-Sectional Studies Ethnic differences Ethnic groups European Continental Ancestry Group - statistics & numerical data Female Health surveys Healthcare Disparities - ethnology Hispanic Americans - statistics & numerical data Hispanic people Humans Immunization Influenza Influenza Vaccines - administration & dosage Influenza Vaccines - supply & distribution Influenza, Human - ethnology Influenza, Human - prevention & control Internal Medicine Logistic Models Male Medicare Minorities Multivariate Analysis Population policy Racial differences United States Vaccination and vaccines Vaccines |
| title | Influenza Vaccine Supply and Racial/Ethnic Disparities in Vaccination Among the Elderly |
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