Journal
CLINICAL INFECTIOUS DISEASES
Volume 73, Issue 11, Pages E4361-E4368Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciaa1484
Keywords
influenza; vaccination; nursing homes; White-Black
Categories
Funding
- National Institute on Aging [R21AG061632]
- National Institute of General Medical Sciences [U54GM115677]
- US Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship in Health Services Research and Development
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The study found that the White-Black gap in influenza vaccination among US NH residents during the 2018-2019 season was 9.9 percentage points, with racial inequities being more prominent at the facility level than at the state level and most concentrated in the Midwestern region.
Background. We sought to determine if racial differences in influenza vaccination among nursing home (NH) residents during the 2008-2009 influenza season persisted in 2018-2019. Methods. We conducted a cross-sectional study of NHs certified by the Centers for Medicare & Medicaid Services during the 2018-2019 influenza season in US states with >= 1% Black NH residents and a White-Black gap in influenza vaccination of NH residents (N = 2 233 392) of at least 1 percentage point (N = 40 states). NH residents during 1 October 2018 through 31 March 2019 aged >= 18 years and self-identified as being of Black or White race were included. Residents' influenza vaccination status (vaccinated, refused, and not offered) was assessed. Multilevel modeling was used to estimate facility-level vaccination status and inequities by state. Results. The White-Black gap in influenza vaccination was 9.9 percentage points. In adjusted analyses, racial inequities in vaccination were more prominent at the facility level than at the state level. Black residents disproportionately lived in NHs that had a majority of Blacks residents, which generally had the lowest vaccination. Inequities were most concentrated in the Midwestern region, also the most segregated. Not being offered the vaccine was negligible in absolute percentage points between White residents (2.6%) and Black residents (4.8%), whereas refusals were higher among Black (28.7%) than White residents (21.0%). Conclusions. The increase in the White-Black vaccination gap among NH residents is occurring at the facility level in more states, especially those with the most segregation.
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