Wide Variation in Flu Vaccination Among Nursing Home Residents in Different Areas

Influenza vaccination disparities between Hispanic and non-Hispanic White US nursing home residents exist across states and hospital referral regions, according to a study published in Open Forum Infectious Diseases.

“Although the racial/ethnic group with the higher likelihood of influenza vaccination differed by geographic region, we found that all states and hospital referral regions fell short of the national Healthy People 2020 vaccination target of 90% for nursing home residents, which was applicable during our study period,” wrote corresponding author Melissa Riester, PharmD, of the Brown University School of Public Health in Providence, Rhode Island, and coauthors.

The study included more than 14 million short-stay and long-stay nursing home resident-seasons between the years 2011 and 2018. Researchers used Medicare data to determine residents’ race/ethnicity and vaccination status, and then calculated percentage point differences in proportions vaccinated between non-Hispanic White and Hispanic (any race) resident-seasons. Positive percentage point differences, where the proportion of non-Hispanic White residents vaccinated was greater than the proportion of Hispanic residents vaccinated, were considered disparities.

Influenza vaccination disparities were most pronounced among short-stay residents and at the state level, according to the study. Among 7.4 million short-stay resident-seasons, the median standardized disparities were 4.3 percentage points across states and 2.8 percentage points across hospital referral regions.

Meanwhile, negative differences in vaccination, in which a greater portion of Hispanic residents were vaccinated, were more pronounced among long-stay residents, researchers reported. Among 6.6 million long-stay resident-seasons, the median standardized differences were −0.1 percentage points and −1.8 percentage points across hospital referral regions.

“Future quality improvement interventions aimed at increasing influenza vaccination in nursing homes nationally should focus on (1) reducing racial/ethnic disparities in geographic areas with the greatest disparities,” the authors advised, “and (2) improving vaccine uptake in geographic areas where the proportion of nursing home residents vaccinated is lowest.”

Reference:
Riester MR, Roberts AI, Silva JBB, et al. Geographic variation in influenza vaccination disparities between Hispanic and non-Hispanic White US nursing home residents. Open Forum Infect Dis. Published online November 24, 2022. doi:10.1093/ofid/ofac634