Addressing Pneumococcal Vaccine Uptake Disparities among African-American Adults in the United States

Abstract

Objective: Pneumococcal illnesses affect over one million Americans annually, making invasive pneumococcal disease (pneumonia) the most prevalent vaccine-preventable illness. Despite well-documented vaccine safety and efficacy, pneumococcal vaccine (PPSV23) uptake remains low, particularly among minorities. This study sought to define variables predicting PPSV23 uptake in eligible African-American (AA) adults.

Design and sample: This was a cross-sectional study using a combined version of the Health Belief (HBM) and Precaution Adoption Process Models (PAPM). A convenience sample of 295 AA adults self-administered the Vaccine Uptake Questionnaire (VUQ).

Measures: Bivariate chi-square analyses were conducted and significant variables evaluated using backward stepwise logistic regression.

Results: PPSV23 uptake was 32.2% (n = 95). Older age, female gender, vaccine awareness, increased knowledge, higher trust scores, perceived susceptibility, and presence of provider recommendation for PPSV23 predicted vaccine uptake. In regression modeling, age, awareness, and provider recommendation remained significant predictors with younger age, unawareness, and lack of provider recommendation decreasing the likelihood of vaccination.

Conclusion: Three dimensions of the HBM (barriers, cues, and susceptibility) predicted PPSV23 uptake. With 147 (47.8%) unaware of PPSV23 existence prior to this study, adding the dimension "unaware" from the PAPM may strengthen the model and assist efforts to increase PPSV23 uptake among AA adults.

Keywords: PPSV23; immunization; pneumococcal; pneumonia; vaccine uptake.