KEYWORDS:
pneumococcal vaccination, influenza vaccination, prevention

BACKGROUND:
Despite the burden of disease caused by influenza and pneumococcus, immunization rates are moderate and have not yet achieved the year 2010 national goals.

OBJECTIVE(S):
This study's objective was to identify patient knowledge, attitudes and beliefs which serve as facilitators of and barriers to influenza and pneumococcal vaccination.

METHOD(S):
A patient survey conducted in 2000 by computer-assisted telephone interviewing. To encounter a broad spectrum of patients and health care systems, we sampled patients at (1) inner-city health centers, (2) Veterans Affairs (VA) outpatient clinics, (3) rural practices, and (4) suburban practices. Inclusion criteria were age > 66 years and an office visit after September 30, 1998. Responses to open-ended questions were categorized using a code book developed for the study. Chi-square tests were performed to compare patients who received the influenza or pneumococcal vaccines versus those who did not with regard to each category of open-ended responses given by respondents.

RESULT(S):
Overall, 1007 (82%) interviews were completed among 1234 contacted by phone. Vaccination against pneumococcal disease was significantly related to being able to accurately describe one or more classic symptoms of pneumonia (P=.05). Vaccination against influenza and pneumococcal disease was significantly related to belief that vaccination was the best way to prevent these diseases (P<.001). The unvaccinated reported that they felt they were not likely to get the flu and that they did not know they needed the pneumococcal vaccine.

CONCLUSIONS(S):
Educational campaigns to increase vaccination rates among older adults should focus on symptoms of, risk for, and severity of influenza and pneumococcal diseases and encouraging physicians to recommend the vaccines to their patients.

LEARNING OBJECTIVES:
To learn patient-reported barriers and facilitators to receipt of the influenza and pneumococcal vaccines.