Barriers and facilitators of pneumococcal vaccination among the elderly.
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.
Zimmerman
Richard Kent
RK
Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, 3518 Fifth Avenue, PA 15261, USA. zimmer@pitt.edu
Santibanez
Tammy A
TA
Fine
Michael J
MJ
Janosky
Janine E
JE
Nowalk
Mary Patricia
MP
Bardella
Inis Jane
IJ
Raymund
Mahlon
M
Wilson
Stephen A
SA
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*
D022242:Pneumococcal Vaccines