Influenza Vaccine Uptake and Missed Opportunities Among the Medicare-Covered Population With High-Risk Conditions During the 2018 to 2019 Influenza Season

Details

• Alternative Title:
  Ann Intern Med
• Personal Author:
  Cho, Bo-Hyun ; Weinbaum, Cindy ; Tsai, Yuping ; Koppaka, Ram
• Description:
  Background:
  
  Seasonal influenza causes substantial morbidity and mortality among older U.S. adults and those with comorbid health conditions.
  
  Objective:
  
  To describe seasonal influenza vaccine uptake and identify factors associated with missed opportunities for influenza vaccination.
  
  Design:
  
  Retrospective cohort study.
  
  Setting:
  
  Medicare fee-for-service claims.
  
  Participants:
  
  31.6 million U.S. adults continuously enrolled under Medicare Parts A and B during the 2018 to 2019 influenza season.
  
  Measurements:
  
  Influenza vaccine uptake and missed opportunities by patient demographic characteristics, high-risk status (that is, ≥1 condition increasing influenza complication risk), Medicare–Medicaid dual-eligibility status, and health care provider visits (that is, vaccination opportunities).
  
  Results:
  
  Overall, 50.5% of beneficiaries aged 19 years or older had Medicare claims for influenza vaccination: 31.6% among people aged 19 to 64 years and 54% among people aged 65 years or older. More White beneficiaries were vaccinated (52.9%) than Black (34.9%) or Hispanic (30.4%) beneficiaries. Uptake was higher (56.1%) for beneficiaries with high-risk conditions than for those without (27.6%). Among unvaccinated beneficiaries overall, 77.4% visited a provider during influenza season; among unvaccinated beneficiaries with and without high-risk conditions, 91% and 43%, respectively, had seen a provider at least once. The proportion of beneficiaries with missed opportunities for influenza vaccination was 44.2% and was higher for beneficiaries in the non–high-risk group (59.1%) than those in the high-risk group (42.2%). Uptake was lower and proportions of missed opportunities were higher among beneficiaries in younger age groups, of Black and Hispanic race/ethnicity, without high-risk conditions, or with Medicare-Medicaid dual eligibility.
  
  Limitations:
  
  Influenza vaccinations without claims could not be captured. Data on reasons for nonvaccination were unavailable.
  
  Conclusion:
  
  Influenza vaccination coverage for Medicare beneficiaries continues to be suboptimal, with missed opportunities despite availability of influenza vaccination with no copayment. Disparities persist in vaccination uptake by race/ethnicity.
  
  Primary Funding Source:
  
  None.
  
  
• Subjects:
  Adult Aged Aged, 80 And Over Article Comorbidity Female Humans Influenza, Human Influenza Vaccines Male Medicare Middle Aged Retrospective Studies Seasons United States Vaccination Coverage

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• Source:
  Ann Intern Med. 175(1):1-10
• Pubmed ID:
  34781717
• Pubmed Central ID:
  PMC9109634
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  175
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:952d3a5ed81388ee16a32b4c3f83c2dbdf82d94e7283d354dfe62f1519faa3c8
• Download URL:
  https://stacks.cdc.gov/view/cdc/117622/cdc_117622_DS1.pdf
• File Type:
  [PDF - 302.44 KB ]