Investigation of barriers to county-level seasonal influenza vaccine uptake among Medicare beneficiaries in the United States – 2018–2019 seasonal influenza season
Introduction: As most public health decisions are made at the local level, public health interventions implemented at the local level may vary by their own unique circumstances, such as demographic composition or the availability of resources. Our objective is to estimate and characterize county-lev...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Vaccine: X |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590136223000670 |
| _version_ | 1827875689440739328 |
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| author | Bo-Hyun Cho Alissa O'Halloran Jamison Pike |
| author_facet | Bo-Hyun Cho Alissa O'Halloran Jamison Pike |
| author_sort | Bo-Hyun Cho |
| collection | DOAJ |
| description | Introduction: As most public health decisions are made at the local level, public health interventions implemented at the local level may vary by their own unique circumstances, such as demographic composition or the availability of resources. Our objective is to estimate and characterize county-level flu vaccine uptakes among Medicare-covered adults aged ≥65 years. Methods: The flu vaccine uptake was estimated from Medicare Fee-for-Service claims for those who continuously enrolled during the 2018–2019 flu season. County-level characteristics were obtained from Centers for Disease Control and Prevention (CDC)’s Minority Health Social Vulnerability Index and Behavioral Risk Factor Surveillance System data as well as Health Resources and Services Administration’s Area Health Resources File. A generalized linear regression was used to assess the relationship between selected characteristics and uptake. Results: A total of 30,265,047 beneficiaries from 3,125 counties were identified, of which 53% received a flu vaccination during the 2018–2019 flu season. For 3,006 counties with more than 500 Medicare beneficiaries, the mean county-level uptake was estimated to be 47.7%. The mean uptakes in counties designated as a health professional shortage area (HPSA) (42.6% and 48.4%, respectively), were lower than the uptakes for the non-HPSA counties (53.8%). Metro counties (53.2%) showed higher uptakes than non-metro counties (44.2%). Regression analysis results showed that the percent of working adults aged 18–64 years and female were positively associated, while the percent of Black and Hispanic adults were negatively associated. Proportions of persons with limited proficiency of English, college education or above, single parent families, multi-unit housing, and living in group quarters were positively associated and significant. Conclusions: The results confirmed that county-level flu vaccine uptakes are low, reflect persistent racial disparities in vaccine uptake, and that Medicare populations in medically underserved communities with lower socioeconomic status need more attention in improving flu vaccine uptake. |
| first_indexed | 2024-03-12T17:11:31Z |
| format | Article |
| id | doaj.art-a7bb2f33ec8a4b71a5573e4d170f76f5 |
| institution | Directory Open Access Journal |
| issn | 2590-1362 |
| language | English |
| last_indexed | 2024-03-12T17:11:31Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Vaccine: X |
| spelling | doaj.art-a7bb2f33ec8a4b71a5573e4d170f76f52023-08-06T04:38:14ZengElsevierVaccine: X2590-13622023-08-0114100326Investigation of barriers to county-level seasonal influenza vaccine uptake among Medicare beneficiaries in the United States – 2018–2019 seasonal influenza seasonBo-Hyun Cho0Alissa O'Halloran1Jamison Pike2Corresponding author at: at: Centers for Disease Control and Prevention, 1600 Clifton Rd NE Mailstop H24-4 Atlanta, GA 30329, United States.; Centers for Disease Control and Prevention, Atlanta, GA, United StatesCenters for Disease Control and Prevention, Atlanta, GA, United StatesCenters for Disease Control and Prevention, Atlanta, GA, United StatesIntroduction: As most public health decisions are made at the local level, public health interventions implemented at the local level may vary by their own unique circumstances, such as demographic composition or the availability of resources. Our objective is to estimate and characterize county-level flu vaccine uptakes among Medicare-covered adults aged ≥65 years. Methods: The flu vaccine uptake was estimated from Medicare Fee-for-Service claims for those who continuously enrolled during the 2018–2019 flu season. County-level characteristics were obtained from Centers for Disease Control and Prevention (CDC)’s Minority Health Social Vulnerability Index and Behavioral Risk Factor Surveillance System data as well as Health Resources and Services Administration’s Area Health Resources File. A generalized linear regression was used to assess the relationship between selected characteristics and uptake. Results: A total of 30,265,047 beneficiaries from 3,125 counties were identified, of which 53% received a flu vaccination during the 2018–2019 flu season. For 3,006 counties with more than 500 Medicare beneficiaries, the mean county-level uptake was estimated to be 47.7%. The mean uptakes in counties designated as a health professional shortage area (HPSA) (42.6% and 48.4%, respectively), were lower than the uptakes for the non-HPSA counties (53.8%). Metro counties (53.2%) showed higher uptakes than non-metro counties (44.2%). Regression analysis results showed that the percent of working adults aged 18–64 years and female were positively associated, while the percent of Black and Hispanic adults were negatively associated. Proportions of persons with limited proficiency of English, college education or above, single parent families, multi-unit housing, and living in group quarters were positively associated and significant. Conclusions: The results confirmed that county-level flu vaccine uptakes are low, reflect persistent racial disparities in vaccine uptake, and that Medicare populations in medically underserved communities with lower socioeconomic status need more attention in improving flu vaccine uptake.http://www.sciencedirect.com/science/article/pii/S2590136223000670Seasonal influenza vaccineMedicareVaccine uptakeSmall area assessmentSocial vulnerability index |
| spellingShingle | Bo-Hyun Cho Alissa O'Halloran Jamison Pike Investigation of barriers to county-level seasonal influenza vaccine uptake among Medicare beneficiaries in the United States – 2018–2019 seasonal influenza season Vaccine: X Seasonal influenza vaccine Medicare Vaccine uptake Small area assessment Social vulnerability index |
| title | Investigation of barriers to county-level seasonal influenza vaccine uptake among Medicare beneficiaries in the United States – 2018–2019 seasonal influenza season |
| title_full | Investigation of barriers to county-level seasonal influenza vaccine uptake among Medicare beneficiaries in the United States – 2018–2019 seasonal influenza season |
| title_fullStr | Investigation of barriers to county-level seasonal influenza vaccine uptake among Medicare beneficiaries in the United States – 2018–2019 seasonal influenza season |
| title_full_unstemmed | Investigation of barriers to county-level seasonal influenza vaccine uptake among Medicare beneficiaries in the United States – 2018–2019 seasonal influenza season |
| title_short | Investigation of barriers to county-level seasonal influenza vaccine uptake among Medicare beneficiaries in the United States – 2018–2019 seasonal influenza season |
| title_sort | investigation of barriers to county level seasonal influenza vaccine uptake among medicare beneficiaries in the united states 2018 2019 seasonal influenza season |
| topic | Seasonal influenza vaccine Medicare Vaccine uptake Small area assessment Social vulnerability index |
| url | http://www.sciencedirect.com/science/article/pii/S2590136223000670 |
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