Factors impacting vaccine uptake among adult Medicaid beneficiaries: a systematic literature review.

Abstract

Vaccine uptake is suboptimal among adult Medicaid beneficiaries. To evaluate factors affecting vaccine uptake among adult Medicaid beneficiaries and/or affecting healthcare providers who vaccinate adult Medicaid beneficiaries, we conducted a systematic literature review in Embase, Medline, Database of Abstracts of Reviews of Effects, and the Cochrane Library for articles published from January 2005 through July 2022 and relevant conferences. For included studies, data were extracted on the study characteristics, patient and provider cost barriers, patient and provider perceived risks/benefits, and other barriers faced by patients and providers. Quality assessments were conducted using a checklist from the Joanna Briggs Institute. Twenty-one studies analyzed patient-related factors (14 studies) and/or provider-related factors (8 studies). Reviewed studies indicate that vaccine uptake is influenced by insurance benefit and cost-coverage policies, including cost-sharing, access to vaccination services, and vaccine education and awareness. Financial factors, including reimbursement for vaccine acquisition and administration, influence providers' vaccination practices for Medicaid beneficiaries. Our findings suggest that reducing or eliminating vaccination cost-sharing, promoting vaccine education and awareness about the importance and safety of vaccines, increasing access, and exploring reimbursement rates equivalent with other public or private insurance plans could mitigate barriers to vaccination for the adult Medicaid population.