BACKGROUND:
There are marked differences in pneumococcal vaccination by race/ethnicity. African Americans and Hispanics have significantly lower pneumococcal immunization coverage rates compared to their white counterparts. The percent of adults aged 65 and older who reported ever receiving pneumococcal vaccine was 60.3% for whites, 37.2% for African Americans, and 27.1% for Hispanics (National Heath Interview Survey, 2002). The reasons for these disparities are not clearly understood.

OBJECTIVE:
To describe the knowledge, attitudes, and immunization practices of adult primary care providers in five southeastern states with respect to pneumococcal immunization, and to determine whether differences exist between providers with predominantly African American populations and those with predominantly white patient populations.

METHOD:
In July 2004, we mailed a 20-item survey to 1,800 internists in five southeastern states (AL, GA, LA, MS, SC). There were a total of three mailings. The random sample of internists was obtained through the American Medical Association (AMA) masterfile. All US licensed physicians in the five target states were eligible if they provided adult care.

RESULT:
Data will be analyzed to determine whether providers with predominantly white patients are different from providers with predominantly African American patients with respect to systematically offering vaccine, use of initiatives to promote vaccination (e.g. provider reminders, standing orders), resources or infrastructure of the practice, time spent with patients, provider attitudes towards vaccination, knowledge regarding immunization disparities, and barriers to vaccination.

CONCLUSION:
Survey responses should provide a better understanding of the factors that affect providers' practice decisions regarding pneumococcal vaccine and whether these play a role in observed disparities.

LEARNING OBJECTIVES:
Participants will understand which factors are associated with pneumococcal vaccine administration and determine if racial/ethnic disparities in immunization can be explained by some of these factors.