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Vaccination Rates Among Patients Age 65 Years and Older Who Require Interpreter Services in the State of Minnesota

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Abstract

In the United States, the growing population of older adults with limited English language proficiency (LEP) faces profound health care disparities. Previous research on vaccination of older adults has been based on self-reported data, without clinical verification. We compared pneumococcal vaccination rates between a patient group with LEP and a group of English speakers in an older community-dwelling population. A population-nested matched cohort of participants age 65 years and older was identified in Minnesota. Patients with LEP were identified through an electronic alert within the electronic health record, designed to determine the need for an interpreter. Patients were matched 1 to 1 for age, sex, and Charlson comorbidity index. We used conditional logistic regression for the final analysis. In total, 24,052 patients were identified as older patients (mean [SD] age, 74 [7] years). Of them, 617 patients (2.6%) had LEP. The most common primary languages were Somali (24%), Vietnamese (15%), and Spanish (13%). We found lower rates of vaccination with 13-valent pneumococcal conjugate vaccine (PCV13) in the LEP group compared with English speakers [62% vs 77%; odds ratio (OR) (95% CI) 2.07 (1.61–2.66); P < 0.001]. Results were similar for 23-valent pneumococcal polysaccharide vaccine (PPSV23) [60% vs 75%; OR (95% CI) 1.97 91.54–2.51); P < 0.001]. These data are suggestive that older adults who required a language interpreter during health care encounters were less likely to be vaccinated with PCV13 and PPSV23 than older adults who did not require an interpreter. Effectiveness studies are needed to determine which interventions can help improve vaccination rates in the LEP population of elderly patients.

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Data Availability

The data that support the findings of this study are available from the corresponding author (M.M.) on reasonable request.

Abbreviations

ECH:

Employee and Community Health

LEP:

Limited English language proficiency

OR:

Odds ratio

PCV13:

13-Valent pneumococcal conjugate vaccine

PPSV23:

23-Valent pneumococcal polysaccharide vaccine

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Acknowledgments

We give special thanks to the Division of Community Internal Medicine at Mayo Clinic for the supportive provision of a study coordinator. We also thank the Office of Health Disparities Research for its work in obtaining data from the health records. This publication was made possible by Clinical and Translational Science Awards Grant Number UL1 TR002377 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH.

Funding

This study received no outside funding.

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Authors and Affiliations

  1. Division of Community Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Maria Mendoza De la Garza, Stephanie M. Quigg & Paul Y. Takahashi

  2. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA

    Silvana B. De Lorenzo

  3. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA

    Darrell R. Schroeder

Authors
  1. Maria Mendoza De la Garza
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  2. Stephanie M. Quigg
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  3. Silvana B. De Lorenzo
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  4. Darrell R. Schroeder
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  5. Paul Y. Takahashi
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Contributions

All authors made substantial contributions to study conception and design. They participated in data acquisition, analysis, and interpretation. All authors participated in drafting the article and revising it critically for important intellectual content and gave final approval of the version submitted.

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Correspondence to Maria Mendoza De la Garza.

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Mendoza De la Garza, M., Quigg, S.M., De Lorenzo, S.B. et al. Vaccination Rates Among Patients Age 65 Years and Older Who Require Interpreter Services in the State of Minnesota. J Community Health 46, 703–710 (2021). https://doi.org/10.1007/s10900-020-00927-4

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