Suboptimal influenza vaccination persists among insurance holders despite no copayment

The coverage of influenza vaccination for Medicare beneficiaries remains poor, reports a study, noting missed opportunities despite availability of vaccines with no copayment. In addition, there are still disparities in vaccination uptake by race/ethnicity.

This retrospective cohort study involved 31.6 million US adults continuously enrolled under Medicare Parts A and B during the 2018 and 2019 influenza season. The investigators assessed vaccine uptake and missed opportunities by patient demographic characteristics, high-risk status, Medicare–Medicaid dual-eligibility status, and healthcare provider visits.

A little over half (50.5 percent) of beneficiaries aged ≥19 years had Medicare claims for influenza vaccination: 31.6 percent among people aged 19–64 years and 54 percent among those aged ≥65 years. White beneficiaries were more likely to get vaccinated than Blacks or Hispanics (52.9 percent vs 34.9 percent and 30.4 percent, respectively).

In addition, influenza vaccination uptake was markedly higher for beneficiaries with high-risk conditions than for those without (56.1 percent vs 27.6 percent).

Overall, 77.4 percent of unvaccinated beneficiaries visited a provider during the influenza season: 91 percent and 43 percent of those with and without high-risk conditions, respectively, had seen a provider at least once.

On the other end, 44.2 percent of beneficiaries had missed opportunities for influenza vaccination, which was higher for those in the nonhigh-risk group compared to individuals in the high-risk group (59.1 percent vs 42.2 percent).

Notably, vaccine uptake was lower and proportions of missed opportunities higher among beneficiaries in younger age groups, of Black and Hispanic race/ethnicity, without high-risk conditions, or with Medicare-Medicaid dual eligibility.

The study was limited by the absence of data on influenza vaccinations without claims and on reasons for nonvaccination.