title: Race/ethnicity and validity of self-reported pneumococcal vaccination.
abstract: BACKGROUND
  National and state surveys show large disparities in pneumococcal vaccination status among Whites, Blacks and Latinos aged >/= 65. The purpose of this study is to determine whether there is any difference in the validity of self-report for pneumococcal vaccination by race/ethnicity that might contribute to the substantial disparities observed in population-level coverage estimates.
  
  
  METHODS
  Self-reported vaccination status was compared with medical record documentation for samples of White, Black, and Latino members of a large health plan to examine whether differences in validity of self-report contribute to observed disparities.
  
  
  RESULTS
  Sensitivity was significantly lower for Blacks (0.849, 95% CI 0.818-0.876) and Latinos (0.869, 95% CI 0.847-0.889) than for Whites (0.931 95% CI 0.918-0.942). Specificity was somewhat higher for Blacks than for Latinos and Whites, but the differences were not statistically significant. Coverage for Whites, Blacks and Latinos, respectively, was 84.3%, 73.5%, and 82.3% based on self-report, but 74.8%, 71.9%, and 84.2% based on medical records.
  
  
  CONCLUSIONS
  The results of this study suggest that differential self-report error, i.e., summative effect of over-reporting and under-reporting within a race-ethnic group, may contribute to the size and direction of race-ethnic disparities in pneumococcal vaccination observed in surveys.
authors.affiliation: Kaiser Permanente Division of Research, Oakland, CA, USA. nancy.gordon@kp.org
authors.forename: Nancy P
authors.initials: NP
authors.lastname: Gordon
authors.forename: Pascale M
authors.initials: PM
authors.lastname: Wortley
authors.forename: James A
authors.initials: JA
authors.lastname: Singleton
authors.forename: Teresa Y
authors.initials: TY
authors.lastname: Lin
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Bardenheier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data; D002140:California; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D011008:Pneumococcal Infections / Q000208:ethnology* / Q000517:prevention & control; D015203:Reproducibility of Results; D012650:Self Disclosure; D014611:Vaccination / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American