Barriers To Elderly Pneumococcal Vaccination

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.

TABLE OF CONTENT

Chapter One            Introduction

1.1         Background of the study

1.2         Statement of the problem

1.3         Purpose of the study

1.4         Significance of study

1.5         Research questions

1.6         Scope of study

1.7         Limitation of study

1.8         Definition of terms

Chapter Two

2.0         Literature Review

Chapter Three

3.0         Methodology

Chapter Four

4.0              Data Analysis

Chapter Five 

5.0         Summary, Conclusion and Recommendations

References Questionnaires