Common Barriers Inhibit Pneumococcal Vaccine Uptake Among Older Adults
The most common barriers to vaccination included finances, logistics, availability of information, and hesitancy or refusal.
Although most health care providers are knowledgeable about pneumococcal vaccination and have a positive attitude toward it, there are several common barriers preventing uptake among older adult patients. Investigators of a recent study published in Vaccine said prioritizing global immunization efforts among this cohort will be critical as the aging population grows.1
Common Barriers Inhibit Pneumococcal Vaccine Uptake Among Older Adults / RFBSIP - stock.adobe.com
Older adults remain at high risk for serious pneumococcal infections like pneumonia and meningitis, despite widespread pediatric vaccination with pneumococcal conjugate vaccines. While childhood vaccination reduces disease through herd immunity, it does not fully protect older adults or those with underlying health conditions. Targeted vaccination strategies for older adults are essential to address the elevated risk and improve protection against invasive disease.2
“The World Health Organization (WHO) has projected that by 2050, there will be 2.1 billion individuals aged 60 and older,” the authors wrote. “Considering the high vulnerability of older adults to pneumococcal disease, the low vaccine uptake in this population is a severe global health concern. In addition, previous research has found that vaccine promotion by healthcare workers plays an essential role in the uptake of vaccines among older adults.”
Investigators from the University of Ottawa conducted a study to assess current pneumococcal immunization practices among health care workers and to identify capability, opportunity, and motivation factors regarding vaccination for older adult patients. Data for the mixed-methods systematic review was gathered from a search of MEDLINE, Embase, CINAHL, AgeLine, Global Health, and Scopus databases for studies published to November 2023.
READ MORE: Pneumococcal Serotype Can Determine Clinical Disease Outcomes
The review included 42 studies, most of which were of cross-sectional design. Of the studies, 18 were conducted in North America, 13 in Europe, 10 in Asia, and 1 was conducted in multiple European countries. Most of the studies were conducted among general or family physicians in primary care settings.
The study found that health care worker practices around pneumococcal vaccination for older adult patients varied widely. Reported rates of administering or recommending the vaccine to elderly patients ranged from 23.7% to 100%. However, one study found that 78% said they prescribe the vaccine throughout the year. Some health care workers said they recommended pneumococcal vaccines more actively to patients 65 years of age and older compared to those 50 years and older with or without underlying chronic diseases. Most health care workers were seen to be knowledgeable and aware of pneumococcal vaccination.
Barriers to pneumococcal vaccination reported by health care workers included high costs to the patient and systems, inadequate reimbursement, unclear guidelines and recommendations, logistical barriers such as insufficient time, inconsistent vaccine supply, and unclear patient vaccination history. Additionally, 80% to 87% of providers said that a clear policy on vaccination would likely increase coverage.
“To improve vaccine uptake, tailored education, clearer guidelines, adequate consultation time, better integration with other health services, and financial support are essential,” the study authors concluded. “Enhancing healthcare workers' capacity and motivation through education, addressing misinformation, and providing incentives can further improve pneumococcal vaccination rates among older adults.”
READ MORE: Pneumococcal Resource Center
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