Abstract
Objectives:
Understanding pneumococcal vaccine uptake across county-level social vulnerability is important for identifying geographic disparities and informing strategies to increase vaccine uptake and reduce the incidence of pneumococcal disease (PD). Using a retrospective cohort design, we characterized differences in vaccine uptake among publicly insured US adults, comparing vaccination rates among beneficiaries in counties with high versus low social vulnerability.
Methods:
We assessed uptake and disease risk using claims for Medicare (aged ≥65 y; 2016-2019) and Medicaid (low income or disabled; 2017-2019) beneficiaries. We measured county-level social vulnerability using the 2021 Minority Health Social Vulnerability Index (overall score and 6 theme scores).
Results:
Of the 56.9 million Medicare beneficiaries analyzed, 36.9% received a pneumococcal vaccine, as did 7.6% of the 8.6 million Medicaid beneficiaries. Vaccine uptake was significantly lower in counties with the highest versus lowest social vulnerability (34.8% vs 38.6% among Medicare beneficiaries,
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Conclusions:
These findings suggest that county- and individual-level factors are associated with disparities in pneumococcal vaccine uptake and underscore the need for tailored clinical, community, and policy strategies to boost pneumococcal vaccine uptake in socially vulnerable populations.