Trends and Racial/Ethnic Disparities in Pneumococcal Polysaccharide Vaccination.

Abstract

Even though pneumococcal vaccination recommendations have been in existence since 1983, vaccination rates are low in the United States. This study analyzed 5-year trends in pneumococcal polysaccharide vaccination uptake across racial/ethnic groups of individuals aged ≥65 years and high-risk individuals aged 19-64 years. Further, it examined factors that may explain the association between race/ethnicity and vaccination uptake. The 2011-2015 annual Behavioral Risk Factor Surveillance System (BRFSS) data were used to determine trends. The Behavioral Model of Health Care Utilization was used to identify covariates in the model. Multivariate logistic regressions were used to identify the association between race/ethnicity and vaccination uptake from 2015 BRFSS. Overall, from 2011 to 2015, vaccination uptake increased moderately from 69% to 71% among those aged ≥65 years, and from 21% to 24% for high-risk individuals aged 19-64 years. Among those aged ≥65 years (n = 99,403), African Americans (adjusted odds ratio [AOR]: 1.36, 95%CI: 1.21-1.52) and Hispanics (AOR: 2.13, 95%CI: 1.85-2.46) were more likely to be vaccinated than Whites. Among the younger population (n = 177,976), African Americans (AOR: 0.85, 95%CI: 0.79-0.92) and Asians (AOR: 0.73, 95%CI: 0.63-0.84) were less likely to be vaccinated than Whites. Over the 5 years there were no significant increases in vaccination uptake. The rates are far below the Healthy People 2020 goals. Reverse disparities were observed in the older group. In younger group, minorities were less likely to get vaccinated. As gaps still exist, this study implies tailored interventions based on race/ethnicity to promote vaccination uptake among both groups.