NEW HAVEN, CT — How do race, ethnicity, sex and rurality affect influenza vaccination adherence in a VHA cohort?
That is the question raised in a recent study in AJPM Focus. It noted that only 53% of American adults receive influenza vaccination, and disparities in vaccination appear to exist among particular racial and ethnic groups.1
The Yale University School of Medicine-led authors examined differences in documented influenza vaccinations for the 2019-2020 influenza season among veterans in a retrospective cohort study using VHA administrative electronic health record data. Also participating in the study were the VA Greater Los Angeles Healthcare System, the VA Connecticut Healthcare System in West Haven, the Va Puget Sound VAMC in Washington, as well as related universities.
Results indicated that, among nearly 6 million veterans, 48.6% received influenza vaccination. “Unadjusted comparisons showed that those who were vaccinated were more likely to be white, to be of male sex, and to be older,” the researchers wrote. “Similar proportions of unvaccinated and unvaccinated veterans were from rural settings.”
Adjusted model most strongly associated Black race with decreased vaccination (AOR=0.69; 95% CI=0.69, 0.70), and American Indian/Alaskan Native race also had reduced odds of vaccination (AOR=0.94; 95% CI=0.92, 0.95) compared with white race. Female veterans, on the other hand, had increased odds of vaccination (AOR=1.20; 95% CI=1.19, 1.20) compared with men.
Rurality (AOR=0.97; 95% CI=0.96, 0.97) was associated with a small decreased odds of vaccination compared with urban, the study team reported.
In stratified models, Black veterans were less likely to receive influenza vaccination regardless of sex and rurality than white veterans, while American Indian/Alaska Native female veterans had equal odds of vaccination as white female veterans, although American Indian/Alaska Native male veterans had reduced odds of vaccination compared with white male veterans.
“During the 2019-2020 influenza season, Black and American Indian/Alaskan Native veterans had lower odds of vaccination,” the researchers concluded. “Despite the Veteran Health Affairs Administration’s universal approach to healthcare, racial disparities still exist in preventive care.”
- Chen AS, Farmer MM, Han L, Runels T, Bade B, Crothers K, Bastian LA, Bazan IS, Bean-Mayberry BA, Brandt CA, Akgün KM. Factors Associated With Influenza Vaccination in a National Veteran Cohort. AJPM Focus. 2024 Oct 21;4(1):100290. doi: 10.1016/j.focus.2024.100290. PMID: 39611140; PMCID: PMC11602634.
