Brief report: risk factors for pneumococcal vaccine refusal in adults: a casecontrol study.
BACKGROUND
Invasive pneumococcal disease is a significant cause of morbidity and mortality in the United States. Despite availability of an effective vaccine, many patients refuse vaccination.


OBJECTIVE
To investigate patient characteristics and features of the patient-provider relationship associated with pneumococcal vaccine refusal.


METHODS
Case-control study using chart review.


METHODS
Five hundred adults from the medical clinics of a 1,000-bed inner-city teaching hospital.


RESULTS
Independent risk factors for pneumococcal vaccine refusal included patient-provider gender discordance (odds ratio (OR)=2.09, 95% confidence interval (CI) 1.07 to 4.09); a visit to a not-usual provider at the time of vaccine offering (OR=2.26, 95% CI 1.13 to 4.49); never having received influenza vaccination (OR=7.44, 95% CI 3.76 to 14.76); prior pneumococcal vaccine refusals (OR=3.45, 95% CI 1.60 to 7.43); and a history of ever having refused health maintenance tests (OR=2.86, 95% CI 1.40 to 5.84).


CONCLUSIONS
We have identified both patient factors and factors related to the patient-provider relationship that are risk factors for pneumococcal vaccine refusal. By identifying patients at risk for pneumococcal vaccine refusal, efforts to increase vaccination rates can be better targeted.
Miller
Lesley S
LS
Division of General Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA. esley.miller@emory.edu
Kourbatova
Ekaterina V
EV
Goodman
Sandy
S
Ray
Susan M
SM
D000368:Aged; D001294:Attitude to Health; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010349:Patient Compliance; D010817:Physician-Patient Relations; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D012189:Retrospective Studies; D012307:Risk Factors; D016312:Treatment Refusal
D022242:Pneumococcal Vaccines