Racial/Ethnic Disparities in Pneumococcal Vaccination Rates Among the Elderly: Trends and Associated Factors in the U.S., 2018-2023
Author(s)
Haeseon Lee, PharmD, MS, Nathorn Chaiyakunapruk, PharmD, PhD;
University of Utah, Salt Lake City, UT, USA
University of Utah, Salt Lake City, UT, USA
OBJECTIVES: Although national pneumonia mortality rates have significantly declined, racial disparities in adult vaccination rates persist, despite improved access to vaccines and healthcare services. This study examined pneumococcal vaccination rates and their associated factors among the elderly population living in the U.S.
METHODS: This cross-sectional study utilized data from the Behavioral Risk Factor Surveillance System (BRFSS) collected between 2018 and 2023. Key variables, including demographics and vaccination status, were harmonized across years to ensure consistency. The analysis focused on individuals aged 65 and older. Descriptive statistics were used to calculate vaccination rates by race/ethnicity, stratified across pre-pandemic (2018 to 2019), during-pandemic (2020 to 2021), and post-pandemic (2022 to 2023) periods. Multivariable logistic regression models were employed to assess the association between race/ethnicity and vaccine uptake, adjusting for sociodemographic and health-related factors. An interaction term between race/ethnicity and the pandemic period was incorporated to explore potential effect modification.
RESULTS: A total of 916,864 individuals were included in the study, comprising 42.9% males and 84.9% White individuals. Across all periods, the Hispanic population had the lowest vaccination rate (48.0%), followed by Non-Hispanic Black (55.5%), Asian (57.0%), Other (57.6%), Native American (58.1%), and White (68.2%). After covariate adjustment, non-Hispanics were found to be 2.12 times more likely to receive the vaccine compared to Hispanics (OR: 2.12, 95% CI: 2.04-2.20). The disparity in vaccination rates was 8% larger in the pre-pandemic period (OR: 1.08, 95% CI: 1.03-1.14) and decreased by 7% in the post-pandemic period (OR: 0.93, 95% CI: 0.88-0.98).
CONCLUSIONS: Pneumococcal vaccination rates were significantly lower among the Hispanic population, with the disparity compared to non-Hispanics remaining pronounced throughout the pandemic period. Addressing this gap requires targeted efforts to promote healthcare equity and improve vaccination uptake among underserved populations.
METHODS: This cross-sectional study utilized data from the Behavioral Risk Factor Surveillance System (BRFSS) collected between 2018 and 2023. Key variables, including demographics and vaccination status, were harmonized across years to ensure consistency. The analysis focused on individuals aged 65 and older. Descriptive statistics were used to calculate vaccination rates by race/ethnicity, stratified across pre-pandemic (2018 to 2019), during-pandemic (2020 to 2021), and post-pandemic (2022 to 2023) periods. Multivariable logistic regression models were employed to assess the association between race/ethnicity and vaccine uptake, adjusting for sociodemographic and health-related factors. An interaction term between race/ethnicity and the pandemic period was incorporated to explore potential effect modification.
RESULTS: A total of 916,864 individuals were included in the study, comprising 42.9% males and 84.9% White individuals. Across all periods, the Hispanic population had the lowest vaccination rate (48.0%), followed by Non-Hispanic Black (55.5%), Asian (57.0%), Other (57.6%), Native American (58.1%), and White (68.2%). After covariate adjustment, non-Hispanics were found to be 2.12 times more likely to receive the vaccine compared to Hispanics (OR: 2.12, 95% CI: 2.04-2.20). The disparity in vaccination rates was 8% larger in the pre-pandemic period (OR: 1.08, 95% CI: 1.03-1.14) and decreased by 7% in the post-pandemic period (OR: 0.93, 95% CI: 0.88-0.98).
CONCLUSIONS: Pneumococcal vaccination rates were significantly lower among the Hispanic population, with the disparity compared to non-Hispanics remaining pronounced throughout the pandemic period. Addressing this gap requires targeted efforts to promote healthcare equity and improve vaccination uptake among underserved populations.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH130
Topic
Epidemiology & Public Health
Disease
STA: Vaccines