Open Access Research article

Race/ethnicity and validity of self-reported pneumococcal vaccination

Nancy P Gordon1*, Pascale M Wortley2, James A Singleton2, Teresa Y Lin1 and Barbara H Bardenheier2

Author Affiliations

1 Kaiser Permanente Division of Research, Oakland, CA, USA

2 Immunization Services Division, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA

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BMC Public Health 2008, 8:227  doi:10.1186/1471-2458-8-227

Published: 3 July 2008



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.


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.


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.


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.