Racial Disparities Among Unvaccinated Patients With SLE

Unvaccinated Medicaid beneficiaries with systemic lupus erythematosus (SLE) are at a greater risk of acute care use for vaccine-preventable illnesses, according to a recent study. Researchers also determined racial disparities to be a contributing factor in the risk association.

 “Nearly 25% of SLE patients are hospitalized yearly, often for outcomes that may have been avoided if patients had received sustained outpatient care. We examined acute care use for vaccine-preventable illnesses to determine sociodemographic contributors and modifiable predictors,” the authors reported.

Utilizing U.S. Medicaid claims (between 2000 and 2010) from 29 states, researchers categorized adults aged 18-65 years with prevalent SLE. Of the 45,654 Medicaid beneficiaries with SLE in the cohort, less than 10% received vaccinations.

“We defined acute care use for vaccine-preventable illnesses as emergency department (ED) or hospital discharge diagnoses for influenza, pneumococcal disease, meningococcal disease, herpes zoster, high-grade cervical dysplasia/cervical cancer, and hepatitis B, after the index date,” the authors wrote. “We estimated the incidence rate (IR) of vaccine-preventable illnesses and used Cox regression to assess risk (HR, 95% CI), by sociodemographic factors and healthcare utilization, adjusting for vaccinations, comorbidities and medications.”

The researchers determined 93% of recorded hospital-related events occurred in unvaccinated patients.

“Patients who were Black compared to White had 22% higher risk. Greater outpatient use was associated with reduced risk, suggesting that access to ambulatory care may reduce avoidable acute care use,” the authors concluded.

—Angelique Platas

Reference:

Feldman CH, Xu C, Costenbader KH. Avoidable acute care use for vaccine-preventable illnesses among Medicaid beneficiaries with lupus. Arthritis Care Res. Published online May 2021.
DOI: https://doi.org/10.1002/acr.24628