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Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2006 Jul;98(7):1089–1094.

Acceptance of pneumococcal vaccine under standing orders by race and ethnicity.

Nicholas A Daniels 1, Susan Gouveia 1, Daniel Null 1, Ginny L Gildengorin 1, Carla A Winston 1
PMCID: PMC2569459  PMID: 16895277

Abstract

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

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Selected References

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