Geospatial Distribution of Racial Disparities in Influenza Vaccination in Nursing Homes.

The study only included geographic units with enough resident-seasons, so it may not describe every state or hospital catchment area, although excluded units had similar age, sex and vaccination distributions. It only included Traditional Medicare beneficiaries aged 65 and older, so it may not apply to younger nursing home residents with disabilities or other Medicare entitlements. It excluded Hispanic, Asian or Pacific Islander, American Indian or Alaska Native, and other race and ethnicity groups, so it does not describe disparities for those residents. The data did not measure all individual-level factors that could affect vaccination, such as why residents refused or staff and facility characteristics beyond what was available, so the study cannot explain the causes of the disparities. The study is observational and reports differences in recorded vaccination status, not the effect of any intervention or policy. Results cover influenza seasons from 2011 to 2018, so they may not reflect more recent seasons, including the COVID-19 pandemic.

Two authors are employed by Sanofi and may hold shares or stock options in the company; the other authors declare no conflicts of interest.

Do not read the percentage point differences as proof that nursing home staff offered vaccines unequally or that a specific intervention would close the gap. The study used administrative records and did not measure why residents refused, staff behavior, or other unmeasured factors.