title: Barriers and facilitators of pneumococcal vaccination among the elderly.
abstract: Despite the burden of disease caused by pneumococcus, adult immunization rates are modest. To understand barriers in diverse settings, we surveyed patients age > or =66 years at: (1) inner-city health centers; (2) Veterans Affairs (VA) outpatient clinics; (3) rural practices; and (4) suburban practices. Among the 1007 respondents, self-reported pneumococcal vaccination rates were: 85% VA; 62% rural; 66% suburban; and 57% inner-city with substantial variability among practices. Half of the unvaccinated (50%) did not know they needed vaccination. Most vaccinees (90%) thought that their doctor believed they should be vaccinated, compared with 23% of the unvaccinated (P<0.0001). More of the vaccinees (75%) believed that the vaccine "keeps a person from getting pneumonia" than the unvaccinated (54%; P=0.0001). In regression analysis, predictors of vaccination included: belief that doctor recommends vaccine, feeling that vaccination is wise, recommendation by someone in the physician's office, and receipt of influenza vaccine.
authors.affiliation: Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, 3518 Fifth Avenue, PA 15261, USA. zimmer@pitt.edu
authors.forename: Richard Kent
authors.initials: RK
authors.lastname: Zimmerman
authors.forename: Tammy A
authors.initials: TA
authors.lastname: Santibanez
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fine
authors.forename: Janine E
authors.initials: JE
authors.lastname: Janosky
authors.forename: Mary Patricia
authors.initials: MP
authors.lastname: Nowalk
authors.forename: Inis Jane
authors.initials: IJ
authors.lastname: Bardella
authors.forename: Mahlon
authors.initials: M
authors.lastname: Raymund
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Wilson
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D022242:Pneumococcal Vaccines