Acceptance of pneumococcal vaccine under standing orders by race and ethnicity.

Purpose: To assess whether and how pneumococcal vaccine acceptance occurs after nurse recommendation varies by race/ethnicity.

Methods: We prospectively evaluated nurses' standing orders to assess and vaccinate high-risk patients in a general medicine practice.

Results: Of 370 adult patients surveyed (60% nonwhite), 78 (21%) declined vaccination following nurse recommendation, and 43 (12%) persisted in declining after physician consultation.