Acceptance of pneumococcal vaccine under standing orders by race and ethnicity

Department of Medicine, University of California, San Francisco, San Francisco, California, United States
Journal of the National Medical Association (Impact Factor: 0.96). 08/2006; 98(7):1089-94.
Source: PubMed


To assess whether and how pneumococcal vaccine acceptance occurs after nurse recommendation varies by race/ethnicity.
We prospectively evaluated nurses' standing orders to assess and vaccinate high-risk patients in a general medicine practice.
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%).
Standing orders, physicians' firm recommendations and addressing patients' vaccine-related concerns may reduce racial/ethnic disparities in vaccination.

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