title: Influenza vaccine supply and racial/ethnic disparities in vaccination among the elderly.
abstract: BACKGROUND
  The impact of vaccine shortages on disparities in influenza vaccination is uncertain.
  
  
  OBJECTIVE
  The objective of this research was to examine the association between influenza vaccine supply and racial/ethnic disparities in vaccination rates among elderly Medicare beneficiaries.
  
  
  METHODS
  Cross-sectional multivariable logistic regression analyses were performed in 2010 to examine whether racial/ethnic disparities in vaccination rates changed across two consecutive seasons: from (Period 1) 2000-2001 and 2001-2002 seasons through (Period 4) 2003-2004 and 2004-2005 seasons. Self-reported receipt of influenza vaccine across consecutive years was examined among community-dwelling non-Hispanic African-American (AA); non-Hispanic white (W); English-speaking Hispanic (EH); and Spanish-speaking Hispanic (SH) elderly enrolled in the Medicare Current Beneficiary Survey (unweighted n=2306-2504, weighted n=8.23-8.99 million for Periods 1 through 4).
  
  
  RESULTS
  During Periods 1 and 2, when vaccine supply increased nationally, adjusted racial/ethnic disparities in the influenza vaccination rate decreased by 1.8%-7.4% (W-AA disparity); 4.5%-6.6% (W-EH disparity); and 6.6%-11% (W-SH disparity) (all p<0.001). During Period 4, when vaccine supply declined, adjusted disparities in vaccination rates increased by 2.3% (W-AA disparity) and 6.1% (W-EH disparity) but decreased by 6.6% (W-SH disparity) probably due to a "floor effect" (constant low rates among SH; all p<0.001).
  
  
  CONCLUSIONS
  Improved vaccine supply was generally associated with reduced racial/ethnic disparities in influenza vaccination rates, whereas worse supply was associated with increased disparities. To avoid future widening of racial health disparities, policy options include stabilizing the vaccine supply and preferential delivery of vaccines to safety-net providers serving AA and Hispanic populations during a shortage.
authors.affiliation: Department of Community and Preventive Medicine, University of Rochester, New York, USA. Byung-Kwang_Yoo@urmc.rochester.edu
authors.forename: Byung-Kwang
authors.initials: BK
authors.lastname: Yoo
authors.forename: Megumi
authors.initials: M
authors.lastname: Kasajima
authors.forename: Charles E
authors.initials: CE
authors.lastname: Phelps
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Bennett
authors.forename: Peter G
authors.initials: PG
authors.lastname: Szilagyi
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000600:supply & distribution*; D007251:Influenza, Human / Q000208:ethnology / Q000517:prevention & control*; D016015:Logistic Models; D008297:Male; D006278:Medicare; D015999:Multivariate Analysis; D014481:United States; D044465:White People / Q000706:statistics & numerical data
chemical_list: D007252:Influenza Vaccines