Influenza vaccination rates for a study group of Medicare recipients were much lower among African Americans (46.1 percent) than among whites (67.7 percent) a gap of 21.6 percentage points.
This racial disparity was reported by researchers at the Harvard School of Public Health, Brigham and Women’s Hospital, and Harvard Medical School who analyzed rates of influenza vaccination and compared racial disparities among enrollees in managed care and those with traditional fee-for-service insurance. The study appears in the Sept. 26 issue of the Journal of the American Medical Association.
Nearly two-thirds of the study participants, 65.8 percent, received the flu vaccination. Managed care enrollees were more likely to receive the vaccine than fee-for-service enrollees (71.2 percent compared with 65.4 percent), but the racial disparity was the same (21.6 percentage points) for those with managed care and those with traditional fee-for-service insurance. The study also found that African Americans were less likely to visit a doctor when they felt they had a problem, although differences in attitudes toward medical care did not explain the racial disparity in rates of flu vaccination.
The five most common reasons among all study participants for not receiving a flu vaccine included “did not know it was needed” (20.6 percent), “thought the shot could cause the flu” (18.4 percent), “thought the shot could have adverse effects” (15 percent), “did not think it would prevent flu” (14.5 percent), and “did not think about it or missed it” (12.6 percent).
The study revealed that other groups of enrollees were also less likely to receive influenza vaccinations, including those reporting Hispanic ethnicity; those who were widowed, divorced, or separated; or those with lower income or attained education.
The researchers examined data from nearly 14,000 Medicare beneficiaries who participated in the 1996 Medicare Current Beneficiary Survey and who identified their race as African American or white. Participants included whites and African Americans who also claimed Hispanic ethnicity. The 1996 Medicare Current Beneficiary Survey is a nationally representative survey.
Eric Schneider, a researcher in the Department of Health Policy and Management at the School of Public Health and a clinician at Brigham and Women’s Hospital, said of the study findings, “Health plans are helping to boost the numbers of people receiving flu shots, especially compared to fee-for-service providers. However, health plans are not having an impact on racial disparities or the ‘flu shot gap,’ and it’s time to start finding solutions to this problem. One answer is for clinicians to tell patients who are 65 or older to get a flu shot every year. However, clinicians cannot solve this problem by themselves. Other programs that reach out to the elderly, and especially those that reach out to African Americans are going to be critically important.”