TY - JOUR
T1 - Influenza and pneumococcal vaccination delivery in older Hispanic populations in the United States
AU - Heintzman, John
AU - Hwang, Jun
AU - Quiñones, Ana R.
AU - Guzman, Cirila Estela Vasquez
AU - Bailey, Steffani
AU - Lucas, Jennifer
AU - Giebultowicz, Sophia
AU - Chan, Brian
AU - Marino, Miguel
N1 - Funding Information:
We acknowledge Roopradha Datta MPH for her assistance in manuscript completion and submission. We also acknowledge the patients, staff, and clinicians of the OCHIN Practice‐Based Research Network. This work was conducted with the Accelerating Data Value Across a National Community Health Center Network (ADVANCE) Clinical Research Network (CRN). OCHIN leads the ADVANCE network in partnership with Health Choice Network, Fenway Health, and Oregon Health and Science University. ADVANCE is funded through the Patient‐Centered Outcomes Research Institute (PCORI), contract number RI‐CRN‐2020‐001.
Publisher Copyright:
© 2021 The American Geriatrics Society
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - electronic health records
KW - Hispanic influenza vaccination
KW - pneumococcal vaccination
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U2 - 10.1111/jgs.17589
DO - 10.1111/jgs.17589
M3 - Article
AN - SCOPUS:85120429330
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
SN - 0002-8614
ER -