Open AccessBrief Report: Risk Factors for Pneumococcal Vaccine Refusal in Adults
Author(s) -
Miller Lesley S.,
Kourbatova Ekaterina V.,
Goodman Sandy,
Ray Susan M.
Publication year - 2005
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1111/j.1525-1497.2005.0118.x
Subject(s) - medicine , vaccination , pneumococcal vaccine , odds ratio , confidence interval , influenza vaccine , pneumococcal infections , pneumococcal disease , pneumococcal conjugate vaccine , pneumococcal polysaccharide vaccine , pediatrics , streptococcus pneumoniae , family medicine , intensive care medicine , immunology , bacteria , genetics , biology
Background: Invasive pneumococcal disease is a significant cause of morbidity and mortality in the United States. Despite availability of an effective vaccine, many patients refuse vaccination. Objective: To investigate patient characteristics and features of the patient–provider relationship associated with pneumococcal vaccine refusal. Design: Case–control study using chart review. Patients: Five hundred adults from the medical clinics of a 1,000‐bed inner‐city teaching hospital. Measurements and Main Results: Independent risk factors for pneumococcal vaccine refusal included patient–provider gender discordance (odds ratio (OR)=2.09, 95% confidence interval (CI) 1.07 to 4.09); a visit to a not‐usual provider at the time of vaccine offering (OR=2.26, 95% CI 1.13 to 4.49); never having received influenza vaccination (OR=7.44, 95% CI 3.76 to 14.76); prior pneumococcal vaccine refusals (OR=3.45, 95% CI 1.60 to 7.43); and a history of ever having refused health maintenance tests (OR=2.86, 95% CI 1.40 to 5.84). Conclusions: We have identified both patient factors and factors related to the patient–provider relationship that are risk factors for pneumococcal vaccine refusal. By identifying patients at risk for pneumococcal vaccine refusal, efforts to increase vaccination rates can be better targeted.