According to the results of a recent study, rates of physician recommendation, administration, and referral related to vaccination differed in adult patients depending on the type of insurance they had (commercial or Medicare).

In order to analyze the relationship of vaccination practices and barriers associated with health insurance type, the study authors conducted a cross-sectional internet-based survey in May 2017. It included 1000 board-certified general/family practitioners and internists from a national US physician panel. The study compared rates of physician recommendation, administration, and referral for influenza, tetanus, diphtheria pertussis (Tdap), and zoster vaccines in adult patients with commercial insurance vs Medicare.

The authors found that similar results were observed for the influenza vaccine regardless of insurance type. For Medicare patients, the rate of physician recommendation, administration, and referral were reported as 84%, 80%, and 11%, respectively. For commercially-insured patients, these rates were reported as 82%, 78%, and 11%.

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However, the  rates of physician recommendation, administration, and referral for the Tdap and zoster vaccines differed based on insurance type. Tdap vaccination recommendation was found to be  significantly higher for commercially-insured patients at 59.4%, whereas it was reported as 54.4% for Medicare patients (P<.001). Additionally, zoster vaccination  recommendation was significantly higher for Medicare patients compared to patients with commercial insurance (59.4% vs 54.7%, respectively; P<.001).

Administration rates for the Tdap and zoster vaccines were found to be higher in commercial patients (64.3% for Tdap, 36% for zoster) compared to Medicare patients (55.6% for Tdap, 32% for zoster), while higher referral rates were observed in Medicare patients (18.6% for Tdap, 49% for zoster) compared to commercially-insured patients (14% for Tdap, 42% for zoster).

“Over 40% of physicians would be much more likely to administer Tdap and zoster vaccines if they were covered under Medicare Part B, with more physicians indicating financial barriers as ‘major’ or ‘moderate’ for Medicare than commercial patients,” the authors wrote, adding, “These differences may be related to financial barriers associated with adult vaccinations that are covered under Medicare Part D and involve patient out-of-pocket costs.”

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This article originally appeared on MPR