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Experimental Human Pneumococcal Carriage

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Pneumococcal vaccination in nursing homes: does race make a difference?

Jill A Marsteller¹, Ronald B Tiggle, Robin E Remsburg

¹Long-term Care Statistics Branch, Division of Health Care Statistics, National Center Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA.

Journal of the American Medical Directors Association

|November 11, 2008

Summary

Black nursing home residents have lower pneumococcal vaccination rates than white residents. Targeted facility interventions can improve immunization for all races.

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Area of Science:

Gerontology
Public Health
Health Disparities

Background:

Pneumococcal vaccination disparities are known in the community.
The nursing home setting, with its controlled environment, was examined for similar disparities.

Purpose of the Study:

To compare pneumococcal vaccination rates between black and white nursing home residents.
To identify facility characteristics interacting with race and vaccination status.

Main Methods:

Analysis of a merged 1997/1999 National Nursing Home Survey dataset.
Multinomial logistic regression used for a nationally representative sample of 14,782 residents aged 65+.

Main Results:

Black residents (31%) were more likely than white residents (24%) to be unimmunized (P < .01).
Racial disparities in pneumococcal vaccination were significant in Medicaid-only and dual-certified facilities.
Black residents had higher odds of unknown vaccination status in Medicaid-only facilities.

Conclusions:

Racial differences in pneumococcal vaccination are concentrated in specific nursing home types.
Facility-based interventions, including immunization programs and improved documentation, can increase vaccination rates across all racial groups.