Barrier to pneumococcal and influenza vaccinations in Black elderly communities: mistrust

Abstract

Objectives: To understand the role of trust of medical institutions in the decision by elderly black Americans to receive pneumococcal and influenza vaccinations.

Design: Cross-sectional, qualitative study, using semistructured in-depth interviews.

Participants: Twenty black Americans age > or = 65 years from two different socioeconomic groups.

Results: Six main themes were identified: prevention, vaccine-caused illnesses, vaccines as irrelevant to health, experience with healthcare, self-advocacy and attitudes toward childhood vaccinations. The majority of vaccinated participants viewed vaccines as a preventive measure, while the unvaccinated group viewed vaccines as irrelevant to their health. In addition, the majority of the participants in the unvaccinated group believed vaccines caused illness. Mistrust of medical institutions or the knowledge of the historical medical injustices was not a significant influence in participant's willingness to be vaccinated against pneumococcal or influenza disease.

Conclusion: Mistrust of medical institutions was not a key concern affecting willingness to be vaccinated in this black community of elderly adults. Participant's willingness to be vaccinated was largely influenced by prior positive or negative experiences with healthcare systems.