Low-income Nevadans enrolled in Medicaid have been vaccinated at far lower rates than the overall population, according to health officials in the state.
In Nevada about 32% of Medicaid enrollees 12 or older have received at least one dose as of August 31, compared to about 58% of the general population — despite months of pro-vaccine campaigns and the increasing ease of getting a shot.
Vaccination rates among Nevada Medicaid recipients, however, have doubled since May when state data showed that the percentage of Medicaid recipients with at least one COVID-19 vaccination was only about 16% compared to 40% of the general population.
In line with trends in statewide vaccination data, the highest percentage of vaccinated Medicaid recipients are in Carson City and Washoe County.
“We’ve seen an improvement since the beginning of the response but … there’s definitely still work to do,” said Candice McDaniel, the health bureau chief within the Nevada Department of Health and Human Services Division of Public and Behavioral Health.
The disparity reveals a strong economic divide between the vaccinated and unvaccinated throughout Nevada. Medicaid is a joint federal and state program that provides health insurance for the most vulnerable populations, including low-income families, adults, children, pregnant women, elderly adults and people with disabilities.
More than 810,000 — or one in four— Nevadans are enrolled in Medicaid or Nevada Check Up, making the programs’ low vaccination rates a major obstacle to the state’s efforts to try to reach herd immunity.
State and county health officials and nonprofit groups have been struggling to reach people in low-income communities. They are trying mobile vaccination clinics, door-to-door canvassing and monetary incentives.
“We really want to understand what those barriers are. Is it transportation? Is it access? Is it time of day? Or is it misinformation?” McDaniel said. “We’re at that point where we are trying to get at the root of what support we can give to make sure we’re breaking down those barriers for this population of people.”
Nevada Medicaid is managed by Amerigroup, Health Plan of Nevada, and SilverSummit Health Plan. The Nevada Department of Health and Human Services is working with the three Medicaid health care administrators to increase vaccination rates among Nevada Medicaid patients.
The Nevada Medicaid provider website has posted information to remind recipients that vaccines are free, as well as inform them how to make a COVID-19 vaccination appointment, and how to find transportation to get vaccinated.
“Nevada Medicaid is working to promote vaccination among Medicaid recipients and is convening meetings to encourage discussion to strategize and develop ideas to connect with Nevada’s hard-to-reach populations,” said Ky Plaskon, a spokesman for the Nevada Division of Health Care Financing and Policy, which oversees Medicaid.
Heidi Parker, executive director of Immunize Nevada, says she’s not surprised that Nevada Medicaid enrollees’ vaccination rates lag the general population’s. State data that tracks vaccination by ZIP code has shown that socio-economic factors affect access to vaccines.
“The pandemic has brought these inequities to light and we were able to form the Nevada Vaccine Equity Collaborative to help focus on solutions,” Parker said. “We know there are still concerns about COVID-19 vaccine cost, losing time from work, transportation barriers and uncertainty of where to go.”
Vaccination rates for regularly scheduled vaccines like measles, mumps, and rubella among adolescent Medicaid patients declined during the pandemic. Data released by the Centers for Medicare and Medicaid Services found that vaccination rates for children fell by 22% compared to the same time period a year earlier.
Pre-pandemic studies show that children on Medicaid were less likely to be fully vaccinated even before COVID-19 spread across the country, according to the Centers for Disease Control and Prevention.
Nevada is far from the only state to with low COVID-19 vaccination rates for Medicaid enrollees.
Earlier this week, the Biden administration announced it is pushing states to use funding from the American Rescue Plan (ARP) to “promote the importance of COVID-19 vaccination for eligible children and adults enrolled in Medicaid.”
The Centers for Medicare & Medicaid Services (CMS) will provide guidance to states to reinforce the understanding that COVID-19 vaccines are available to nearly all Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries for free.
Additionally, ARP temporarily makes 100% federal matching funds available for states’ Medicaid and CHIP expenditures for COVID-19 vaccine administration.