title: Pneumococcal infection--low awareness as a potential barrier to vaccination: results of a European study.
abstract: BACKGROUND
  Elderly people and adults with chronic disease or compromised immune status are at increased risk of pneumococcal infection, with pneumonia being the most common serious presentation and a significant cause of morbidity and mortality. Most European countries have recommendations for pneumococcal vaccination but vaccination rates have remained low. In the present article, the authors present the results of a European survey that investigated the current level of awareness of pneumococcal infection among primary care physicians and specialists, and attitudes to vaccination in these physicians and members of the general public aged >50 years.
  
  
  METHODS
  Primary care physicians (n = 1,300) and specialists (n = 926) from 13 Western European countries participated in online/face-to-face interviews, and a further 6,534 individuals aged >50 years from a population sample reflecting local socio-demographic structure participated in telephone/face-to-face interviews.
  
  
  RESULTS
  Pneumonia was the most well-known of the pneumococcal infections amongst primary care physicians and specialists. However, there was a relatively low awareness of the term invasive pneumococcal disease (IPD), with only 50% of primary care physicians and 71% of specialists reporting knowledge of the term IPD. Key factors influencing a physician's decision to prescribe pneumococcal vaccination were the patient's health condition, recommendations from health authorities, and the tolerability of the vaccine. Perceptions regarding vaccination were good amongst the members of the general public; individuals did not fear vaccines or their side effects. The main drivers for vaccination were recommendations from a healthcare professional and, to a lesser extent, that vaccination provides reassurance against contracting a disease.
  
  
  CONCLUSIONS
  These findings highlight the low awareness of the term IPD in comparison with individual pneumococcal conditions. Given the importance of physician recommendations in encouraging patients to be vaccinated, primary care physicians need to be vigilant of patients at risk of pneumococcal infections in order to increase vaccination rates.
authors.affiliation: Research Centre for Medical Studies, Institute of Clinical Pharmacology, Charité Universitätsmedizin Berlin, Reichsstr 2, Berlin, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Lode
authors.forename: Endre
authors.initials: E
authors.lastname: Ludwig
authors.forename: George
authors.initials: G
authors.lastname: Kassianos
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D058007:Physicians, Primary Care / Q000523:psychology / Q000706:statistics & numerical data*; D011008:Pneumococcal Infections / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D014611:Vaccination / Q000523:psychology / Q000706:statistics & numerical data*