Role of provider's perceptions on immunization in a minority prenatal Medi-Cal population in Los Angeles County

Background: Research has shown that provider recommendations influence patients' decisions to obtain immunizations. Latinos have typically been more receptive to provider recommendations than other minority patient populations, such as African-Americans.

Objective: To assess providers' perception of probable immunization behaviors among minority populations and the role provider bias may play in immunization trends.

Methods: A 10-item electronic survey on demographics, perceived barriers to vaccination and providers' perceptions of patients' willingness to vaccinate was sent to 381 Comprehensive Perinatal Service Program providers in Los Angeles County. Responses were collected electronically over 10 days and analyzed using descriptive and inferential statistics.

Results: Eleven percent of providers completed the survey (43/381). Twenty-one percent (9/43) did not provide any immunizations and the rest offered at least one. The patient population was made up of Latinos (76%), Caucasians (8%) and African-Americans (7%). Physicians perceived Latinos more likely to obtain vaccinations (89% either likely or very likely) compared to African-Americans/Caucasians (75%). Twenty-six percent of providers (11/43) specifically rated Latinos more likely to obtain vaccinations than African-Americans.

Conclusion: Provider biases of patients' probable immunization behaviors may impact the clinical approach to vaccinations by playing a role in vaccine purchase and storage, counseling, and offering. The provider's approach, in turn, impacts patients' final immunization practices. Consistently lower rates of immunization among African-Americans may be influenced by provider behaviors towards different patient populations, and thus, the role of physician bias needs to be further explored and understood as a potential cause of perpetuating known racial/ethnic immunization disparities.