National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, Georgia.
National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, Georgia.
Am J Prev Med. 2022 Nov;63(5):790-799. doi: 10.1016/j.amepre.2022.06.002. Epub 2022 Jul 26.
Influenza vaccination is the best prevention strategy to protect against influenza infection. Determining accurate influenza vaccination coverage is critical. This study assesses the concordance between self-reported and claimed-based influenza vaccination coverage and examines vaccination disparities in the U.S.
Data from the 2016-2019 Medicare Current Beneficiary Survey linked to survey participants' influenza vaccination claims were analyzed in 2022. The study population included survey participants aged ≥65 years and enrolled in a Medicare fee-for-service plan. Sensitivity, specificity, kappa statistics, and net bias (the difference between the estimated vaccination coverage based on survey and claims data) were reported. Associations between receipt of influenza vaccine and beneficiaries' characteristics and sex, racial and ethnic, and urban‒rural disparities in influenza vaccination were examined using logistic regressions.
The analysis included 20,854 beneficiaries. Claimed-based vaccination coverage was 60.0%, and survey-based coverage was 76.3%. The net bias was 16.3 percentage points, and kappa statistic indicated moderate data agreement. The sensitivity of self-reported influenza vaccination was 98.7%, and the specificity was 57.4%. Net bias was high among male, non-Hispanic Black and Hispanic beneficiaries, and rural residents. Sex, racial and ethnic, and urban‒rural disparities in influenza vaccination were noticeably smaller according to the survey than claims data.
The level of data agreement differed by beneficiaries' characteristics and was low among males, racial and ethnic minority groups, and rural residents.
流感疫苗接种是预防流感感染的最佳策略。准确确定流感疫苗接种率至关重要。本研究评估了自我报告和基于申报的流感疫苗接种覆盖率之间的一致性，并检查了美国的疫苗接种差异。
对 2022 年 2016-2019 年医疗保险当前受益人调查（Medicare Current Beneficiary Survey）的数据进行了分析，这些数据与调查参与者的流感疫苗接种申报相关联。研究人群包括年龄≥65 岁且参加医疗保险按服务收费计划的调查参与者。报告了敏感性、特异性、kappa 统计量和净偏差（基于调查和申报数据估计的疫苗接种覆盖率之间的差异）。使用逻辑回归检查了流感疫苗接种与受益人的特征以及性别、种族和民族以及城乡差异之间的关联。
分析包括 20854 名受益人的数据。基于申报的疫苗接种覆盖率为 60.0%，基于调查的疫苗接种覆盖率为 76.3%。净偏差为 16.3 个百分点，kappa 统计量表明数据一致性为中度。自我报告的流感疫苗接种敏感性为 98.7%，特异性为 57.4%。在男性、非西班牙裔黑人和西班牙裔受益人和农村居民中，净偏差较高。根据调查，与申报数据相比，性别、种族和民族以及城乡差异在流感疫苗接种方面明显较小。
数据一致性水平因受益人的特征而异，男性、少数族裔和农村居民的数据一致性较低。
