Barriers and facilitators of pneumococcal vaccination among the elderly

Vaccine. 2003 Mar 28;21(13-14):1510-7. doi: 10.1016/s0264-410x(02)00698-9.


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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Female
  • Humans
  • Male
  • Multivariate Analysis
  • Pneumococcal Vaccines / administration & dosage*
  • Pneumococcal Vaccines / immunology
  • Vaccination / statistics & numerical data*


  • Pneumococcal Vaccines