Racial/Ethnic Variation in Veterans Health Administration COVID-19 Vaccine Uptake.

Haderlein TP, Wong MS, Jones KT, Moy EM, Yuan AH, Washington DL. Racial/Ethnic Variation in Veterans Health Administration COVID-19 Vaccine Uptake. American journal of preventive medicine. 2022 Apr 1; 62(4):596-601.

Related HSR&D Project(s)

• SDR 20-402 – Multi-level Factors Underlying VA Racial/Ethnic Disparities in Covid-19 Infection and Complications
• IIR 17-289 – Mitigating Racial/Ethnic and Socio-Economic Disparities in VA Care Quality and Patient Experience

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Abstract:

INTRODUCTION: Equitable COVID-19 vaccine access is imperative to mitigating negative COVID-19 impacts among racial/ethnic minorities. U.S. racial/ethnic minorities have lower COVID-19 vaccination rates than Whites despite higher COVID-19 death/case rates. The Veterans Health Administration provides the unique context of a managed care system with few access barriers. This study evaluates race/ethnicity as a predictor of Veterans Health Administration COVID-19 vaccination. METHODS: The cohort was composed of Veterans Health Administration outpatient users aged = 65 years (N = 3,474,874). COVID-19 vaccination was assessed between December 14, 2020 and February 23, 2021. Multivariable logistic regressions were conducted, controlling for demographics, medical comorbidity, and influenza vaccination history. Proximity to Indian Health Service Contract Health Service Delivery Areas was tested as a moderator. Data analyses were conducted during 2021. RESULTS: Blacks (OR = 1.28, 95% CI = 1.17, 1.40), Hispanics (OR = 1.15, 95% CI = 1.05, 1.25), and Asians (OR = 1.21, 95% CI = 1.02, 1.43) were more likely than Whites to receive Veterans Health Administration COVID-19 vaccinations. American Indian/Alaska Natives were less likely than Whites to receive Veterans Health Administration COVID-19 vaccinations, but only those residing in Contract Health Service Delivery Area counties (OR = 0.58, 95% CI = 0.47, 0.72). Influenza vaccine history positively predicted COVID-19 vaccine uptake (OR = 2.28, 95% CI = 2.22, 2.34). CONCLUSIONS: In the Veterans Health Administration, compared with the general U.S. population, COVID-19 vaccine receipt is higher among most racial/ethnic minority groups than Whites, suggesting reduced vaccination barriers . The Indian Health Service may provide a safety net for American Indian/Alaska Native populations. Addressing vaccination access barriers in non-Veterans Health Administration settings can potentially reduce racial/ethnic disparities.