Characterizing Social Determinants of Health in the Population Receiving Pneumococcal Vaccine in a National Pharmacy Chain in the United States
Author(s)
Laura Lupton, MHA, MD, Xiaowu Sun, PhD, Shiyu Lin, MS, Sravanthi Mikkilineni, B.Tech, Leena Samuel, MS, Joaquim Fernandes, MS;
CVS Health, Woonsocket, RI, USA
CVS Health, Woonsocket, RI, USA
Presentation Documents
OBJECTIVES: The Centers for Disease Control (CDC) recommends pneumococcal vaccination for older adults. Socially vulnerable populations may experience barriers which limit their access to healthcare. This study describes the social vulnerability characteristics of patients receiving pneumococcal vaccination at a national pharmacy chain.
METHODS: Pneumococcal vaccination records were identified from the CVS immunization research database. There are about 9,000+ CVS Pharmacy locations in local neighborhoods across the United States. CDC Social Vulnerability Index (SVI) was linked to the CVS immunization database by zip code of patient’s residence. Patients were segmented into quintiles based-on the overall SVI and its 4 constituent themes and 16 factors. The first and fifth quintiles indicate the least and most vulnerable communities, respectively.
RESULTS: From April 2021 to December 2024, there were 2,327,917 patients aged 50 and older who received pneumococcal vaccination. Patients were 19.2% 50-64 years and 80.8% 65 years or older, and 56.0% female. By US region, there were Northeast 21%, South 42%, Midwest 13%, and West 24%. Within the pneumococcal vaccinated population, 2.5%, 11.7%, 21.1%, 26.2%, 38.5% fell into first to fifth quintiles of overall SVI, respectively. The 4th and 5th quintiles together accounted for 64.7% of the population, demonstrating greater social vulnerability than would be expected in the general population, with only a combined 14.2% falling into the 1st and 2nd quintiles. The strongest drivers of social vulnerability within the combined 4th and 5th quintiles were: 63.5% of those with vulnerability Housing Cost Burden; 73.4% of those with vulnerability Housing Type/Transportation; 74.9% of those with vulnerability Racial & Ethnic Minority Status; and 81.6% of those with vulnerability English Language Proficiency.
CONCLUSIONS: A high percentage of the population receiving pneumococcal vaccination at national pharmacy chain came from highly vulnerable communities. Community-based vaccination may help to address barriers to healthcare access in vulnerable communities.
METHODS: Pneumococcal vaccination records were identified from the CVS immunization research database. There are about 9,000+ CVS Pharmacy locations in local neighborhoods across the United States. CDC Social Vulnerability Index (SVI) was linked to the CVS immunization database by zip code of patient’s residence. Patients were segmented into quintiles based-on the overall SVI and its 4 constituent themes and 16 factors. The first and fifth quintiles indicate the least and most vulnerable communities, respectively.
RESULTS: From April 2021 to December 2024, there were 2,327,917 patients aged 50 and older who received pneumococcal vaccination. Patients were 19.2% 50-64 years and 80.8% 65 years or older, and 56.0% female. By US region, there were Northeast 21%, South 42%, Midwest 13%, and West 24%. Within the pneumococcal vaccinated population, 2.5%, 11.7%, 21.1%, 26.2%, 38.5% fell into first to fifth quintiles of overall SVI, respectively. The 4th and 5th quintiles together accounted for 64.7% of the population, demonstrating greater social vulnerability than would be expected in the general population, with only a combined 14.2% falling into the 1st and 2nd quintiles. The strongest drivers of social vulnerability within the combined 4th and 5th quintiles were: 63.5% of those with vulnerability Housing Cost Burden; 73.4% of those with vulnerability Housing Type/Transportation; 74.9% of those with vulnerability Racial & Ethnic Minority Status; and 81.6% of those with vulnerability English Language Proficiency.
CONCLUSIONS: A high percentage of the population receiving pneumococcal vaccination at national pharmacy chain came from highly vulnerable communities. Community-based vaccination may help to address barriers to healthcare access in vulnerable communities.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HPR116
Topic
Health Policy & Regulatory
Topic Subcategory
Health Disparities & Equity
Disease
STA: Vaccines