Pneumococcal vaccination in general internal medicine practice: current practice and future possibilities

J Gen Intern Med. 2008 Dec;23(12):2010-3. doi: 10.1007/s11606-008-0800-0. Epub 2008 Oct 2.


Background: Pneumococcal vaccine (PPV) is recommended for adults >or=65 years and those with chronic illness, but there are potential advantages of universal vaccination of adults age 50-64 years.

Objective: To assess reported (1) recommendations and administration practices of general internists for PPV, (2) barriers to vaccination, and (3) willingness to expand vaccination to all adults >or=50 years.

Methods: National survey of general internists representative of the American College of Physicians.

Results: Response rate was 74% (N = 326). Although 99% reported giving PPV, less than 20% used a computerized database to identify eligible patients by age or diagnoses and only 6% recalled patients. Major barriers included acute problems taking precedence over preventive care (39%), difficulty determining vaccination history (30%), not thinking of it/not a priority (20%), and inadequate reimbursement for vaccine (19%). If ACIP expanded recommendations, 60% would definitely and 37% would probably institute this change.

Conclusions: Most general internists reported giving PPV, but delivery was hindered by competing demands, lack of systems to identify patients needing vaccination, and reimbursement issues. Barriers might be decreased by a policy of universal vaccination of adults >or=50 years, and the majority of physicians reported they would follow such a recommendation if it were made.

Publication types

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

MeSH terms

  • Age Factors
  • Attitude of Health Personnel
  • Data Collection / methods
  • Data Collection / trends
  • Family Practice / methods
  • Family Practice / standards
  • Family Practice / trends*
  • Humans
  • Internal Medicine / methods
  • Internal Medicine / standards
  • Internal Medicine / trends*
  • Middle Aged
  • Pneumococcal Vaccines / therapeutic use*
  • Practice Guidelines as Topic / standards
  • Vaccination / methods
  • Vaccination / trends*


  • Pneumococcal Vaccines