Influenza Vaccination Coverage Among Medicare Fee-for-Service Beneficiaries

Introduction: 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. Methods: 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. Results: 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. Conclusions: The level of data agreement differed by beneficiaries' characteristics and was low among males, racial and ethnic minority groups, and rural residents.