title: Barrier to pneumococcal and influenza vaccinations in Black elderly communities: mistrust.
abstract: OBJECTIVE
  To understand the role of trust of medical institutions in the decision by elderly black Americans to receive pneumococcal and influenza vaccinations.
  
  
  METHODS
  Cross-sectional, qualitative study, using semistructured in-depth interviews.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Family Medicine, University of Rochester, NY 14620, USA. lewanza_harris@urmc.rochester.edu
authors.forename: LeWanza M
authors.initials: LM
authors.lastname: Harris
authors.forename: Nancy P
authors.initials: NP
authors.lastname: Chin
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
authors.forename: Sharon
authors.initials: S
authors.lastname: Humiston
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011008:Pneumococcal Infections / Q000517:prevention & control*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014611:Vaccination