Elderly African-Americans and the influenza vaccine: the impact of the primary care physician

Abstract

Background: Despite recommendations for annual vaccinations against influenza, many older African-Americans do not receive this vaccine. For 1 month in our private medical offices, we conducted a survey to estimate the vaccination rate for our practice, the reasons why older African-Americans declined to be vaccinated, and any impact we could make on their misconceptions about its safety and efficacy.

Setting: The study was conducted in a three-physician private practice of geriatric/internal medicine in the borough of Queens, New York.

Participants: 231 consecutive community-residing patients aged 65 or older were evaluated starting in October 1999.

Methods: A total of 231 patients aged 65 to 96 were given a questionnaire asking if they planned to or had already received the influenza vaccine for the 1999-2000 season. Those who had no intention of taking the vaccine were asked why. Categories included: Vaccine not recommended/not recommended strongly enough, vaccine has no benefit, I became ill after being vaccinated, too afraid, I heard it makes people sick, no special reason, allergy to eggs, never had the flu. Those who refused had a brief discussion with their physician and it was noted whether they agreed later to be vaccinated. Ten patients who were not black were excluded.

Results: Forty-four percent (98/221) of patients intended to be vaccinated before discussion with their physician. After discussion with their physician about potential side effects, efficacy,safety, the percentage rose to 63% (139/221). This compares favorably with the national health objective of 60% or greater for the year 2000 in this population.

Conclusions: The primary care physician had a significant impact on the increase of the influenza vaccination rate among older African-Americans in our study from 44 to 63%.