title: Barriers to pneumococcal and influenza vaccination in older community-dwelling adults (2000-2001).
abstract: OBJECTIVE
  To identify facilitators of and barriers to vaccination in patients from a range of socioeconomic levels.
  
  
  METHODS
  A survey was conducted in 2001 using computer-assisted telephone interviewing.
  
  
  METHODS
  Patients from inner-city health centers and suburban practices were interviewed.
  
  
  METHODS
  Inclusion criteria were aged 66 and older and an office visit after September 30, 1998.
  
  
  METHODS
  Self-reported influenza and pneumococcal vaccination status and facilitating conditions, attitudes, social influences, and perceived consequences from the Triandis model were assessed.
  
  
  RESULTS
  Overall, 557 interviews were completed with 775 eligible patients (72%). Patients who reported having received pneumococcal vaccine more frequently believed that their physicians recommended the vaccine than did the unvaccinated (97% vs 49%; P=.001). This was also true for influenza vaccine (99% vs 80%; P<.001). More unvaccinated patients than vaccinated patients felt that obtaining either vaccine was more trouble than it is worth (pneumococcal 19% vs 1%; P=.04, influenza 20% vs 1%; P=.004). The vaccinated were more likely to be willing to obtain the influenza and pneumococcal vaccines at the same time (pneumococcal 91% vs 59%; P=.002, influenza 91% vs 55%; P=.014).
  
  
  CONCLUSIONS
  Physicians should take every opportunity to recommend vaccination to their eligible adult patients. Offering influenza and pneumococcal vaccines at the same visit is an acceptable means to ensure that adults are fully vaccinated.
authors.affiliation: Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261, USA.
authors.forename: Mary Patricia
authors.initials: MP
authors.lastname: Nowalk
authors.forename: Richard K
authors.initials: RK
authors.lastname: Zimmerman
authors.forename: Shunhua
authors.initials: S
authors.lastname: Shen
authors.forename: Ilene K
authors.initials: IK
authors.lastname: Jewell
authors.forename: Mahlon
authors.initials: M
authors.lastname: Raymund
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D016015:Logistic Models; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines