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

Filetype[PDF-302.44 KB]


  • English
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    Details:

    • Alternative Title:
      Ann Intern Med
    • Publisher's site:
    • Personal Author:
    • 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:
    • 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/
    • Collection(s):
    • Main Document Checksum:
    • Download URL:
    • File Type:

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