Brief Report

Journal of General Internal Medicine

, Volume 23, Issue 12, pp 2010-2013

Pneumococcal Vaccination in General Internal Medicine Practice: Current Practice and Future Possibilities

  • Allison KempeAffiliated withDepartment of Pediatrics, University of Colorado DenverPreventive Medicine and Biometrics, University of Colorado DenverColorado Health Outcomes Program, University of Colorado DenverChildren’s Outcomes Research Program, The Children’s Hospital Email author 
  • , Laura HurleyAffiliated withGeneral Internal Medicine, University of Colorado DenverDivision of General Internal Medicine, Denver Health
  • , Shannon StokleyAffiliated withNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention
  • , Matthew F. DaleyAffiliated withDepartment of Pediatrics, University of Colorado DenverColorado Health Outcomes Program, University of Colorado DenverChildren’s Outcomes Research Program, The Children’s Hospital
  • , Lori A. CraneAffiliated withPreventive Medicine and Biometrics, University of Colorado DenverColorado Health Outcomes Program, University of Colorado DenverChildren’s Outcomes Research Program, The Children’s Hospital
  • , Brenda L. BeatyAffiliated withColorado Health Outcomes Program, University of Colorado DenverChildren’s Outcomes Research Program, The Children’s Hospital
  • , L. Miriam DickinsonAffiliated withFamily Medicine, University of Colorado Denver
  • , Christine BabbelAffiliated withChildren’s Outcomes Research Program, The Children’s Hospital
  • , Jennifer BarrowAffiliated withChildren’s Outcomes Research Program, The Children’s Hospital
    • , John F. SteinerAffiliated withGeneral Internal Medicine, University of Colorado DenverPreventive Medicine and Biometrics, University of Colorado DenverColorado Health Outcomes Program, University of Colorado Denver

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Abstract

Background

Pneumococcal vaccine (PPV) is recommended for adults ≥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 ≥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 ≥50 years, and the majority of physicians reported they would follow such a recommendation if it were made.

KEY WORDS

immunization delivery pneumococcal vaccine pneumococcus pneumonia