Rural/Urban Disparities in Pneumococcal Vaccine Service Delivery Among the Fee-for-Service Medicare Population

Overview of Key Findings In 2014, the overall mean vaccination rate in urban areas was 4.66 compared to a mean vaccination rate of 2.81 in rural areas, indicating a 40% lower mean vaccination rate in rural communities. The majority of pneumococcal vaccine services delivered to fee-for-service Medicare beneficiaries were provided by primary care providers, although pharmacy providers delivered close to one-fourth (22.2%) of these services. The proportion of pneumococcal vaccine services delivered by pharmacy providers was significantly greater in rural versus urban counties (29.4% vs. 21.1%). Consistent with previous literature, county characteristics positively associated with pneumococcal vaccine service delivery include increasing age of residents, more female residents, and availability of inpatient hospital services, while rurality, poverty, and greater overall health status were negatively associated with delivery of pneumococcal vaccine services.