BACKGROUND:
Research has shown that racial/ethnic disparities in adult influenza vaccination persist even after consideration of income and educational status. The extent to which disparities result from providers being less likely to recommend vaccination to minority patients, versus patients declining to accept immunization, is unknown.

OBJECTIVE:
1)To estimate the percent of Medicare seniors whose physicians recommended influenza vaccination in the 2002 flu season
2)To compare physician recommendation to patient vaccination status by race

METHOD:
We investigated influenza recommendation and vaccination in a survey of seniors sampled from the Medicare enrollment database in the five sites which were part of the Racial and Ethnic Adult Disparities in Immunization Initiative (READII).

RESULT:
Of 4633 Medicare beneficiaries surveyed, 55% reported that a health care provider recommended influenza vaccination during fall or winter 2002. We found no significant differences by race, with 55% of Caucasians, 54% of African Americans, and 53% of Hispanics reporting provider recommendation. Seniors who received a provider recommendation were more likely to be vaccinated (84%) than seniors who did not report provider recommendation (56%). Among those who reported provider recommendation, 88% of Caucasians were vaccinated, compared to 80% of Hispanics and 66% of African Americans. Among those who did not report provider recommendation, 61% of Caucasians, 50% of Hispanics, and 33% of African Americans were vaccinated.

CONCLUSION:
Provider recommendation for influenza vaccination did not differ by race in our sample. Participants who reported provider recommendation were more likely to be vaccinated. However, African American and Hispanic seniors were less likely to be vaccinated than Caucasians despite provider recommendation. Provider messages regarding vaccination may need to be tailored to specific patients to improve vaccine acceptance.

LEARNING OBJECTIVES:
Participants will be able to describe influenza vaccination status by provider recommendation among Medicare seniors responding to the READII survey.