Exploring Vaccine Uptake among African American Adults

Background: Pneumococcus is the bacteria responsible for three major invasive diseases: pneumonia, bacteremia, and meningitis. These illnesses affect over one million annually making pneumococcal disease the most prevalent and dangerous of all vaccine preventable illnesses. Despite safety and efficacy, pneumococcal vaccine (PPSV23) uptake remains challenging particularly among minority populations. The purpose of this study was to examine variables thought to predict PPSV23 uptake among African American (AA) adults whose age or chronic conditions rendered them PPSV23 eligible. Methods: A substructed version of the Health Belief and Precaution Adoption Process Models served as the theoretical underpinning. A quantitative cross-sectional exploratory design using convenience sampling was utilized to survey AA adults. Bivariate analyses were conducted using chi-square. An empirical model with variables found to be statistically significant was then evaluated using backward stepwise logistic regression. Findings: Despite eligibility, only 95 of 295 (32.2%) reported PPSV23 uptake. Older age, female gender, vaccine awareness, increased knowledge, higher trust scores, perceived susceptibility, and presence of provider recommendation for PPSV23 were significant predictors of vaccine uptake in bivariate analyses. In the regression model, age, awareness, and provider recommendation remained significant with younger participants four times less likely to be vaccinated, those unaware six times less likely, and those without a provider recommendation seven times less likely to be vaccinated. Conclusion: Consistent with existing literature, three dimensions of the HBM (barriers, cues, and susceptibility) were significant predictors of PPSV23 uptake.  Interventions aimed at increasing PPSV23 awareness and bolstering healthcare provider recommendation for vaccination should therefore be considered.