There continue to be significant racial and ethnic disparities in rates of childhood and adult immunizations in the United States. The causes are multifactorial, including inequities in education, income, and socioeconomic status; structural and systemic barriers in the health care delivery system; and beliefs, preferences, and practice patterns of the recipients and providers of care. Elimination of these disparities is a targeted priority in Healthy People 2010. The individual clinician can contribute to the narrowing of this gap by being informed of and using available national and regional resources, implementing national standards for culturally and linguistically appropriate health care services, and using every clinical encounter to assure that vaccination is offered and provided. Specific action steps are suggested.