Disparities in Respiratory Syncytial Virus Vaccine Uptake in the Medicare Fee-for-Service Population During 2023-2024 Season.

Abstract

Background: Respiratory syncytial virus (RSV) is a common cause of acute respiratory illness and can lead to serious morbidity and mortality in older adults. With the Food and Drug Administration approval and the Centers for Disease Control and Prevention (CDC) recommendation of RSV vaccines in 2023, this study describes first season vaccine uptake in adults ≥ 65 years.

Methods: In a retrospective cohort of 100% Medicare Fee-for-Service (FFS) beneficiaries with Part D coverage, we examined RSV vaccination claims data from July 2023 to June 2024. Cumulative RSV vaccine uptake rates were evaluated by demographic, socioeconomic, and health characteristics, along with evaluation of vaccine coadministration. We reported descriptive statistics.

Results: Among 15,841,938 Medicare FFS beneficiaries meeting inclusion criteria, 3,330,740 (21.0%) received the RSV vaccine in the first season. Uptake was highest among the 75-84 age group (23.6%) and those with at least one comorbidity (21.8%). Additionally, those with immunocompromising conditions (23.6%) and lung disease (21.3%) had the highest uptake. The lowest uptake was observed among beneficiaries ≥ 85 years (17.1%), beneficiaries with three or more comorbidities, (19.4%) and those in the southern census region (19.3%). The lowest uptake according to comorbidity status were those with liver disorders (17.1%) and neurologic or neuromuscular conditions (17.8%). Disparities were observed with only 6.8% of Hispanic, 12.6% of Black, 9.3% of those with a low-income subsidy (LIS), and 9.0% of dual Medicare-Medicaid eligible beneficiaries receiving the vaccine. Coadministration occurred in 38.4% of RSV vaccinations.

Conclusions: Vaccination to prevent RSV disease began during the 2023-2024 season where less than a quarter of the Medicare FFS population was vaccinated. Disparities in uptake were observed by race and ethnicity, socioeconomic status, geography, comorbidity status, and by age group. These results highlight the need for more targeted public health efforts to improve vaccination among those at high risk for severe RSV disease.