Lower flu vaccination rates at dialysis sites with more Black, Hispanic vs white patients
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A study of dialysis facilities across the Unites States showed centers that treated a larger proportion of Black and Hispanic patients had lower rates of seasonal influenza vaccination than centers that had more white patients.
Further, according to John Danziger, MD, of Beth Israel Deaconess Medical Center at Harvard Medical School, and colleagues, these disparities in vaccination appear to be “worsening” over time.
“These disparities, which show no signs of improvement in recent years, are particularly poignant amid the current coronavirus disease 2019 pandemic, which has disproportionately affected minorities,” the researchers contended, adding that these groups are also disproportionately affected by kidney disease and at greater risk for infection than many other populations due to their extensive contact with health care professionals.
Therefore, Danziger and colleagues assessed vaccination rates among 6,735 Medicare-certified facilities. The proportion of patients vaccinated for influenza during peak season, defined as Aug. 1 to Dec. 31, was ascertained for each dialysis facility, with the researchers also considering how vaccination percentages changed each flu season between 2014 and 2017.
Determining the mean percentage of patients vaccinated during the influenza season to be 72.1%, Danziger and colleagues observed facilities with higher proportions of Black and Hispanic patients had significantly lower vaccination percentages than facilities with a higher proportion of white patients. More specifically, the researchers found a 10% increment in proportion of patients who were Black and Hispanic was associated with a 0.60% and 0.79% lower percent vaccinated, respectively.
“Facilities did not vaccinate an average of approximately 25% of patients, more so in those with larger proportions of Black and Hispanic patients,” the researchers elaborated.
Further findings indicated the average proportion of patients vaccinated at each facility decreased significantly from 2014 to 2017 (a decrease of 1.05% vaccinated per year). This decrease was more pronounced among facilities with higher multiracial proportions, with the share of vaccinated patients in facilities in the quartile with the highest proportion of Black patients decreasing 1.21% per year vs. a decrease of 0.88% per year in facilities in the quartile with the lowest proportion of Black patients. Findings were similar for Hispanic patients.
Danziger and colleagues pointed out that the potential consequences of vaccination disparities are important not only to individual patients but to public health.
“Universal and widespread vaccination is essential to conferring community protection; that dialysis facilities with higher proportions of minority patients or those located in areas with higher proportions of Black residents had lower vaccination percentages highlights the heightened risks for minority communities,” they wrote.
They added that dialysis facilities will play a growing role in a national vaccination effort, especially when considering a COVID-19 vaccine to control the pandemic in the long term.
“Achieving uniform vaccination will be instrumental to protecting Americans equitably,” the researchers concluded.
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