How can you improve vaccination rates among older African Americans? Patients want you to address their fear of drug interactions and allergic reactions

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From: Journal of Family Practice(Vol. 56, Issue 11)
Publisher: Jobson Medical Information LLC
Document Type: Report
Length: 2,542 words
Lexile Measure: 1410L

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Practice recommendations

* Recommend the flu shot and make it convenient to get vaccinated.

* Tell your patients that the flu is a serious illness and that they may be susceptible, even if they haven't had it before. Reinforce the idea that they should practice good hygiene, such as washing their hands regularly.

* Tell patients that the flu shot is safe; it will not give them the flu or interact with any of their medications.

* Give patients printed materials. Excellent resources are available through the CDC ( or the National Institute of Allergy and Infectious Disease (


Purpose Adults 65 and older are at greatest risk for complications and death from influenza, yet one third of those at risk do not receive the influenza vaccine; African American vaccination rates are even lower. This study explored older African Americans' concerns about getting the flu vaccine and vaccine providers' level of awareness of these concerns.

Methods Focus groups and in-depth interviews were conducted among African Americans who were 50 years of age and older, and vaccine providers.

Results Older African Americans' fear of getting the flu from vaccination was widespread, as were concerns about vaccine interaction with medications and allergic reactions. Older African Americans also doubted the vaccine's effectiveness, and distrusted both the vaccine and the healthcare system. For their part, providers understood patients' concerns and recognized that fear of illness caused by the shot was a major issue. They did not, however, recognize the importance of asking about, and discussing, patients' fears of allergies and medication interactions when administering the vaccine.

Conclusions In order to improve vaccination rates among older African Americans, health care providers would be wise to take the time to discuss the vaccine and address vaccine efficacy, safety, side effects, and drug interactions.

Why are older African Americans less likely than whites to get a flu vaccination? Despite the existence of an effective flu vaccine, usage rates still remain low: 66% on average, (1) and are even lower among minority groups. (2) One survey found only 47% of older African Americans were vaccinated against the flu. (3)

These disparities are not easily explained. Even when controlling for increased risk, age distribution, perceived health status, family size and marital status, poverty level, education, and access to medical care and health insurance, African Americans are still less likely than whites to get vaccinated. (3,4)

In light of this disparity, we explored barriers to flu vaccination among this population, including concerns over safety and adverse events, and the role that health care providers can play in overcoming these issues.

* What are the barriers?

Structural factors, such as having access to a location that provides vaccinations, (5) and social factors, such as believing that others support vaccination, (6) increase vaccination rates. Vaccination increases with ages; and is more likely in those who have previously been vaccinated. (8)

People who believe they aren't susceptible to a disease are less likely to get vaccinated. (9,10) Fear of side effects is also a significant barrier. (2,6,7,11,12)...

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Gale Document Number: GALE|A171442525