COVID-19 Testing and Vaccination among US Older Adults with Vision Impairment: The National Health and Aging Trends Study 2021

Purpose To examine the associations between vision impairment (VI) and COVID-19 testing and vaccination services in older US adults. Methods This cross-sectional study assessed data from adults ≥65 years who participated in the National Health and Aging Trends Study (year 2021), a nationally representative sample of Medicare beneficiaries. Exposure: Distance VI (<20/40), near VI (<20/40), contrast sensitivity impairment (CSI) (<1.55 logCS), and any VI (distance, near, or CSI). Outcomes: Self-reported COVID-19 testing and vaccination. Results Of 2,822 older adults, the majority were female (weighted; 55%) and White (82%), and 32% had any VI. In fully-adjusted regression analyses, older adults with any VI had similar COVID-19 vaccination rates to adults without any VI (OR:0.77, 95% CI:0.54–1.09), but had lower odds of COVID-19 testing (OR:0.82, 95% CI:0.68–0.97). Older adults with distance (OR:0.47, 95% CI:0.22–0.99) and near (OR:0.68, 95% CI:0.47–0.99) VI were less likely to be vaccinated for COVID-19, while those with CSI were less likely to test for COVID-19 (OR:0.76, 95% CI:0.61– 0.95), as compared to peers without respective impairments. The remaining associations were not significant (p>.05). Conclusions and Relevance These findings highlight inequities in the COVID-19 pandemic response for people with vision disability and emphasize the need for equitable prioritization of accessibility of healthcare services for all Americans.