Learning Objectives for this Presentation:
By the end of the poster presentation participants will be able to:
1. Discuss a framework for defining and addressing health disparities in a managed care population.
2. Identify the three most common reasons for non-vaccination.


Background:
Use of preventive care services are increased in managed care vs. fee for service. However, with pneumococcal immunization, we found data indicating a disparity in vaccination rates between African American and Caucasian patients despite a system of equal access to care, insurance coverage, and outreach efforts.

Objectives:
To determine the reasons for non-vaccination among African American and Caucasian patients in a managed care population in the Southeastern US.

Methods:
Telephone survey with unvaccinated patients at five clinics who were age 18 and older (n=1,845) with coronary artery disease, congestive heart failure or diabetes and those over age 64 (n=1198) without co-morbidities. In each group we looked at race, gender and education.

Results:
The primary reason for non-vaccination for African Americans and Caucasians in the 18 and older group and the over age 64 group was that the patient “did not know” they needed shot. The reasons for non-vaccination in the 18 and older group did not vary by race (p=.2074), education (p=.8454), or gender (p= .0959). Likewise in the over 64 group, we found no significant difference by race (p=.3612), education (p=.1424) and gender (p=.4128).

Conclusions:
The number one reason for non-vaccination for African American and Caucasian patients was “did not know” they needed shot regardless of gender or educational level. Ensuring that systems are in place that would heighten patient awareness, encourage practitioner referral and provide access could positively impact the vaccination rate.