IDWeek 2023: Race/Ethnicity and Level of Area Deprivation Impact Vaccination Rates for Influenza and Bivalent COVID-19

This article is part of our IDWeek 2023 coverage. You can find all of our news here.

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A cross-sectional study of more than 300 000 outpatient visits to a large metropolitan hospital system revealed racial disparities in vaccination rates for influenza and bivalent COVID-19, and that the impact of race and ethnicity on vaccination rates depend on the level of community deprivation.

The findings are being presented during a poster session at IDWeek 2023, being held from October 11-15 in Boston, MA.

“Negative influenza and COVID-19—associated outcomes, such as hospitalizations and intensive care unit admission rates disproportionately impact Black, Hispanic, and Native American or Alaska Native individuals,” wrote presenting author Anuja Sarode, MPH, biostatistician, University Hospitals (UH), Cleveland, Ohio, and colleagues. “Targeted influenza and COVID-19 vaccine coverage could improve in minority groups.”

Investigators conducted the study to examine the role of race-ethnicity and resource inequity in influenza and COVID-19 vaccine coverage. Sarode and coauthors analyzed data from 300 300 outpatient visits at UH from October 1, 2022, to April 31, 2023, according to the abstract. Race-ethnicity, age, sex, income, residence zip code, personal income, and influenza and bivalent COVID-19 immunization records were collected.

Patients were considered immunized if they received an influenza vaccine between July 1, 2022, and April 31, 2023, and a bivalent COVID-19 vaccine between September 1, 2022, and April 31, 2023.

Researchers used a 9-digit patient zip code to collect state Area Depravity Index (ADI) data provided by the University of Wisconsin School of Medicine and Public Health. The ADI ranks US neighborhoods by socioeconomic disadvantage at the state or national level and “includes factors for the theoretical domains of income, education, employment, and housing quality,” according to the University of Wisconsin School of Medicine and Public Health. The state ADI ranges from 1 to 10, with group 1 being the least disadvantaged and 10 being the most disadvantaged, according to the abstract.

“An adjusted and stratified logistic regression analysis was utilized to estimate the odds for being vaccinated predicted by race-ethnicity, age, sex, personal income, and state ADI.”

Patient ages were grouped into 3 categories: aged 18-49 years, 50-64 years, and ≥65 years.

FINDINGS

Results from the adjusted logistic regression analysis showed that non-Hispanic Black patients had a 13% lower (median odds ratio [MOR] 0.87, 95% CI 0.85-0.89) likelihood of getting the influenza vaccine compared to non-Hispanic White patients. Investigators also found that a higher ADI predicted lower odds of receiving both the influenza vaccine and bivalent COVID-19 vaccine.

When researchers looked at different age groups in the adjusted analysis, they observed that non-Hispanic Black adults and those with a higher ADI were less likely to receive the influenza vaccine across all age groups. As for bivalent COVID-19 vaccination, race did not play a significant role, but an increase in ADI and lower income strongly predicted lower vaccination rates across all age groups, added Sarode and colleagues.

“These findings highlight specific subgroups that should be targeted for future efforts in preventing influenza and COVID-19,” concluded Sarode et al. “However, it's important to note that the generalizability of this study is limited, and conducting similar analyses in different regions with varying vaccine coverage would be beneficial.”

Source: Role of race-ethnicity and area deprivation in influenza and bivalent COVID-19 vaccine coverage. Abstract presented at IDWeek; October 11-15, 2023; Boston, MA.

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