BACKGROUND:
National data show that elderly African-Americans and Hispanics are vaccinated against pneumococcal disease less frequently than whites. Reasons for those differences are poorly understood.

OBJECTIVE:
To examine attitudes towards pneumococcal vaccination in the baseline Racial and Ethnic Adult Disparities in Immunization Initiative (READII) survey.

METHOD:
Medicare beneficiaries residing in the five READII demonstration sites were randomly sampled and contacted via the telephone from February to April 2003. Participants were categorized as either vaccinated, willing-to-be vaccinated, or refusers. Refusers were those who reported a doctor recommendation for vaccination and were unvaccinated, as well as those who stated they would not get vaccinated if it were recommended to them by a doctor.

RESULT:
Seventy-three percent of whites, 46% of African-Americans, and 56% of Hispanics were vaccinated; 19%, 35%, and 34%, respectively, were willing-to-be vaccinated; and 8%, 19%, and 10%, respectively, were refusers. Among those willing-to-be vaccinated, the leading reasons for nonvaccination were not knowing the vaccine was needed (43%) and not receiving a doctor recommendation for vaccination (23%). Not knowing the vaccine was needed (33%) and thinking they were not at risk for pneumonia (23%) were the leading reasons for nonvaccination in the refusers. Nonvaccination due to concerns about the vaccine among refusers was more common for African-Americans (22%) than for whites and Hispanics (13% and 12%). Receipt of the influenza vaccine in fall 2002 was reported by 88% of the vaccinated, 53% of those willing-to-be vaccinated, and 25% of the refusers. Similar patterns were observed for each race.

CONCLUSION:
Since a large proportion of unvaccinated African-Americans and Hispanics are willing-to-be vaccinated, the implementation of systems that will ensure the routine offering of pneumococcal vaccination could have a substantial impact on coverage. Specific messages may be needed, however, to address concerns about the vaccine among African-Americans in particular.

LEARNING OBJECTIVES:
Participants will be able to describe differences in pneumococcal vaccination by race/ethnicity.