Racial Disparities in Immunizations and the New Maternal Immunization HEDIS® Measure


One of the best public health successes has been the reduction of infectious diseases through vaccination. Vaccinations have helped eliminate smallpox, largely eradicated polio, and reduced rates of hepatitis, measles, mumps, tetanus, pertussis, and diphtheria. Yet, there is still poor uptake of vaccines today, especially among racial minorities. Disparities in immunizations are apparent across the life span, as well as across racial and educational lines. Many African Americans especially feel a sense of awareness about their racial being in the health care setting and have more distrust about vaccines. Other reported reasons for not getting vaccinated include:

  • Concerns the vaccine will make them get the disease
  • Concerns about the ingredients in vaccines
  • Dislike/fear of needles
  • Belief that getting the disease will provide better immunity
  • Belief that “I am healthy and do not need vaccines”
  • Preference for alternative medicines

Describing the problem of racism in immunizations is the easy part – having a conversation about fixing it is the hard part. Knowledge does not change fear-based view of risk. In the age of social media misinformation, vaccine hesitancy is at an all-time high. The research on vaccine hesitancy is only a few years old, so the process of addressing vaccine hesitancy in minorities and people of color is in its infancy. Distrust of the medical profession runs deep in the Black community. Racism has been widespread in all aspects of the health care industry, including midwifery.

How we begin to have this conversation will be the topic of a presentation at the ACNM 66th Annual Meeting, held virtually May 23-25, 2021. This presentation will also discuss the National Quality Forum’s new Healthcare Effectiveness Data and Information Set (HEDIS) measure on prenatal immunizations.