Richard K. Zimmerman1, Tammy A. Santibanez
2, Janine E. Janosky
1, Michael J. Fine
3, Mahlon Raymund
4, Stephen Wilson
5, Inis J. Bardella
1, A.R. Medsger
4, and Mary Patricia Nowalk
1. (1) Family Medicine & Clinical Epidemiology, University of Pittsburgh, 3518 Fifth Avenue, Pittsburgh, PA, USA, (2) National Immunization Program, CDC, 1600 Clifton Road, NE, Mailstop E-62, Atlanta, GA, USA, (3) Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA, (4) University of Pittsburgh, Pittsburgh, PA, USA, (5) Family Practice Residency, UPMC-St.Margaret, 815 Freeport Road, Pittsburgh, PA, USA
KEYWORDS:
influenza vaccination, prevention, immunization programs, utilization
BACKGROUND:
Despite strong evidence of the effectiveness of influenza vaccination, immunization rates have reached a plateau that is below the 2010 national goals; pneumococcal vaccination levels are even lower.
OBJECTIVE:
To identify facilitators of, and barriers to, vaccination in diverse groups of older patients.
METHOD:
A survey was conducted in 2000 in the Pittsburgh region by computer-assisted telephone interviewing of patients from inner-city health centers, Veterans Affairs (VA) outpatient clinics, rural practices, and suburban practices. The inclusion criteria were age 66 years or older and an office visit after September 30, 1998.
RESULT:
Overall, 1007 (73%) interviews were completed among 1383 patients. Influenza vaccination rates were 91% at VA clinics, 79% at rural practices, 79% at suburban practices, and 67% at inner-city health centers. There was substantial variability in vaccination rates among practices, except at the VA. Nearly all persons who were vaccinated reported that their physicians recommended influenza vaccinations, compared with 63% of unvaccinated patients (P <0.001). 38% of unvaccinated patients were concerned that they would get influenza from the vaccine, compared with only 6% of vaccinated persons (P <0.001). 63% of vaccinees, in contrast with 22% of unvaccinated persons, thought that an unvaccinated person would probably contract influenza (P <0.001).
Among the 1007 respondents, self-reported pneumococcal vaccination rates were: 85% VA, 62% rural, 66% suburban, and 57% inner-city. 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<.0001).
CONCLUSION:
Older patients need intentional messages recommending vaccination from their physicians. Furthermore, more patient education is needed to counter myths about adverse reactions.
LEARNING OBJECTIVES:
To examine patient reported determinants of and barriers to adult immunization.
See more of Barriers to Adult Immunization: Findings from Recent Studies
See more of The 37th National Immunization Conference
