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Influenza Vaccine Supply Affects Racial and Ethnic Disparities in the Elderly

Vaccine shortages and delays may exacerbate racial and ethnic disparities in influenza vaccination among elderly Medicare beneficiaries, a new analysis suggests.

The study appears in the January 2011 issue of the American Journal of Preventive Medicine.

Researchers employed a cohort analysis of populations followed-up during 2 consecutive seasons with different vaccine supply. For all groups, the vaccination rate generally increased when vaccine supply improved and decreased when vaccine supply declined.

"The current study provides a rigorous test of the hypothesis that racial/ethnic disparities in influenza vaccination rates are worse when vaccine supply is delayed or limited," write Byung-Kwang Yoo, MD, PhD, from the University of Rochester School of Medicine, New York, and colleagues.

Racial and ethnic disparities have been consistently documented for influenza vaccination among adults aged 65 years and older, with lower vaccination rates among Hispanic and black populations than among whites. These disparities persist despite evidence that influenza vaccination reduces morbidity and is cost-effective.

Researchers analyzed the 2000 to 2005 Medicare Current Beneficiary Surveys in 2010 for levels and time trends within 4 periods. The multipurpose survey offers a nationally representative sample of the Medicare population. Participants are queried about their health experience 3 times a year for 4 years. Survey data are combined with their Medicare claims. Response rates were 66% to 82% during the study period.

The study population consisted of community-dwelling non-Hispanic black, non-Hispanic white, and Hispanic Medicare beneficiaries aged 65 years and older. Analyses for each period examined the same cohort — those enrolled in the survey for 2 consecutive influenza seasons. Because earlier research indicates that white–Hispanic disparities are largely explained by language differences, English-speaking Hispanic and Spanish-speaking Hispanic beneficiaries were distinguished based on whether they used Spanish in answering the questions.

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