Racial Inequity in Receiving Flu Vaccination among Nursing Home Residents

Objectives: Nursing home (NH) residents are vulnerable to influenza and related complications. However, NH vaccination rates are still suboptimal, especially for black residents. The objectives of this study are to: (1) describe the trend of flu vaccination rates in NHs over years; and (2) examine the sources of racial inequity in flu vaccination among NH residents. Design: Nationwide 2006-2010 Nursing Home Compare data, 2006-2008 MDS, and 2007 OSCAR data were used. NHs were stratified into quintiles based on the concentration of blacks served. We (1) calculated the proportion of facilities that had low vaccination rates (< 75% of long-stay residents vaccinated) during the flu season for each study year; and (2) estimated logit, fixed- and random-effects logit models to examine the overall, within- and between-NH racial differences in the receipt of flu vaccines, for each quintile and flu season separately. Findings: There are improvements in the proportion of facilities with low flu vaccination rates between 2006 and 2010; gains were greatest among facilities serving a high proportion of blacks. Nonetheless, ongoing inequity in receiving flu vaccination between black and white NH residents exists. This inequity comes from both within-facility differences (blacks are less likely to receive vaccination than whites in the same facility) and between-facility variations related to proportion blacks (blacks are more likely to reside in NHs with overall lower flu vaccination rates). Conclusions: Although flu vaccination rates in NHs have improved over a fairly short period of time, the racial inequity of receiving flu vaccination still exist.