Acceptance of pneumococcal vaccine under standing orders by race and ethnicity

J Natl Med Assoc. 2006 Jul;98(7):1089-94.

Abstract

Purpose: To assess whether and how pneumococcal vaccine acceptance occurs after nurse recommendation varies by race/ethnicity.

Methods: We prospectively evaluated nurses' standing orders to assess and vaccinate high-risk patients in a general medicine practice.

Results: Of 370 adult patients surveyed (60% nonwhite), 78 (21%) declined vaccination following nurse recommendation, and 43 (12%) persisted in declining after physician consultation. Three-hundred-twenty-seven (88%) patients accepted vaccination: 292 (79%) accepted following nurse recommendation and 35 (9%) following physician consultation. African Americans (19%) were significantly more likely to decline compared with whites (8%) and Asians (5%) (P= 0.01). Reasons for refusal included believing vaccination was unnecessary (32%), fearing shots in general (21%), fearing vaccine-induced illness (26%) and wanting more informotion regarding the vaccine (9%).

Conclusion: Standing orders, physicians' firm recommendations and addressing patients' vaccine-related concerns may reduce racial/ethnic disparities in vaccination.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Americans / psychology*
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nurses
  • Patient Acceptance of Health Care / ethnology*
  • Pneumococcal Infections / ethnology*
  • Pneumococcal Infections / prevention & control
  • Pneumococcal Vaccines / administration & dosage*
  • Prospective Studies
  • United States / epidemiology
  • Vaccination / statistics & numerical data*

Substances

  • Pneumococcal Vaccines