PROVIDENCE, RI — Racial disparities in receipt of high-dose influenza vaccine (HDV) have been documented nationally, but a new study sought to determine if small-area geographic variation in such disparities also exists.
To answer that question, researchers from Brown University School of Public Health, the Providence, RI, VAMC and colleagues assessed the distribution of disparities in HDV receipt between Black and white traditional Medicare beneficiaries vaccinated against influenza within states and hospital referral regions (HRRs).
The nationally representative retrospective cohort study focused on 11,768,724 community-dwelling traditional Medicare beneficiaries vaccinated against influenza during the 2015-2016 influenza season (94.3% white and 5.7% Black). Results were published in the Journal of Racial and Ethnic Health Disparities.1
“Our comparison was marginalized vs. privileged racial group measured as Black vs. white race,” the researchers explained. “Vaccination and type of vaccine were obtained from Medicare Carrier and outpatient files. Differences in the proportions of individuals who received HDV between Black and White beneficiaries within states and HRRs were used to measure age- and sex-standardized disparities in HDV receipt. We restricted to states and HRRs with ≥ 100 beneficiaries per age-sex strata per racial group.”
The researchers said they detected a national disparity in HDV receipt of 12.8 percentage points (pps). “At the state level, the median standardized HDV receipt disparity was 10.7 pps (minimum, maximum: 2.9, 25.6; n = 30 states),’ they wrote. “The median standardized HDV receipt disparity among HRRs was 11.6 pps (minimum, maximum: 0.4, 24.7; n = 54 HRRs).”
The study authors said they determined that Black beneficiaries were less likely to receive HDV compared to white beneficiaries in nearly every state and HRR in the analysis, adding, “The magnitudes of disparities varied substantially across states and HRRs. Local interventions and policies are needed to target geographic areas with the largest disparities to address these inequities.”
- Silva JBB, Howe CJ, Jackson JW, Riester MR, Bardenheier BH, Xu L, Puckrein G, van Aalst R, Loiacono MM, Zullo AR. Geographic Variation in Racial Disparities in Receipt of High-Dose Influenza Vaccine Among US Older Adults. J Racial Ethn Health Disparities. 2023 May 15:1–10. doi: 10.1007/s40615-023-01628-z. Epub ahead of print. PMID: 37184814; PMCID: PMC10184628.