Influenza and pneumococcal vaccination delivery in older Hispanic populations in the United States

John Heintzman, Jun Hwang, Ana R. Quiñones, Cirila Estela Vasquez Guzman, Steffani R. Bailey, Jennifer Lucas, Sophia Giebultowicz, Brian Chan, Miguel Marino

Research output: Contribution to journalArticlepeer-review


Introduction: National reports suggest that Hispanic patients may underutilize influenza and pneumococcal vaccination, although studies sometimes conflict on this point. A clearer picture of adult immunization utilization in older Hispanic patients is necessary to ensure equity in adult vaccinations. Methods: Using electronic health records from 648 community health centers (CHCs) across 21 states, we compared English-preferring Hispanic patients, Spanish-preferring Hispanic patients, and Non-Hispanic White (NHW) adults aged ≥50 years across five outcomes between 2012–2017: (1) Odds of ever receiving pneumococcal vaccination after age 65, (2) Odds of ever receiving ≥2 pneumococcal vaccinations for those ≥65, (3) odds of vaccination between the ages of 50 and 64 for those with diabetes or heart disease, (4) odds of influenza vaccine, and (5) annual rate of influenza vaccination. Results: Of our total study sample (N = 143,869), 85,562 were age 50–64 during the entire study period, and 65,977 were ≥65 at some point during the study period. In patients aged 50–64, Spanish-preferring Hispanic patients were more likely to have ever had an influenza vaccination (covariate-adjusted odds ratio [aOR] = 1.33, 95% CI = 1.29–1.37), had higher rates of annual influenza vaccination (covariate-adjusted rate ratio [aRR] = 1.41, 95% CI = 1.38–1.44), and higher odds of pneumococcal vaccination (aOR = 1.87, 95% CI = 1.76–1.98) than NHW patients. These findings were similar in Spanish-preferring Hispanic patients ≥65. English-preferring Hispanics ≥65 were less likely than NHW patients to ever have an influenza vaccination (aOR = 0.91, 95% CI = 0.85–0.98) and to have ever received at least one (aOR = 0.92, 95% CI = 0.86–0.99) or two (aOR = 0.86, 95% CI = 0.77–0.95) pneumococcal vaccine doses. Conclusions: In a multistate CHC network, Spanish-preferring Hispanic patients were more likely to receive influenza and pneumococcal vaccinations than NHW patients; older English-preferring Hispanic patients were often less likely than NHW patients to receive these vaccinations. In vaccine initiatives, English-preferring Hispanic patients may be at higher risk of vaccination inequity.

Original languageEnglish (US)
Pages (from-to)854-861
Number of pages8
JournalJournal of the American Geriatrics Society
Issue number3
StatePublished - Mar 2022


  • Hispanic influenza vaccination
  • electronic health records
  • pneumococcal vaccination

ASJC Scopus subject areas

  • Geriatrics and Gerontology


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