Impact of a Doctor's Verbal Recommendation on Pneumococcal 13-Valent Conjugate Vaccine among High-Risk Patients for Pneumonia in a Primary Care Setting

Abstract

Background: Streptococcus pneumoniae is the main bacterial pathogen of community-acquired pneumonia in Korea. This study aimed to enhance the vaccination rate by evaluating the effectiveness of current methods of recommendation.Methods: A retrospective analysis of the medical records of 143 patients with high risk of pneumonia among first-visit outpatients was conducted. High-risk patients for pneumonia are defined by the U.S. Advisory Committee on Immunization Practices. One hundred and twenty-seven patients, excluding 16 with pneumococcal 13-valent conjugate vaccination (PCV13) history prior to the first visit, were divided into three groups according to the method of vaccination recommendation: banner (B) group; banner+brochure (B+Br) group; banner+brochure+doctor's recommendation (B+Br+DR) group. The vaccination rates among patients in each group were compared.Results: Patients with high risk of pneumonia showed 11.2% rate for PCV13 vaccination upon their first visit;however, this rate increased to 39.2% following counseling (P<0.001). Variation among the three groups was as follows: 9.0% in the B group, 20.0% in the B+Br group, and 75.0% in the B+Br+DR group (P<0.001). After adjusting for age, sex, high-risk group, occupation, and residence, a regression analysis was carried out. The odds ratio for the PCV13 vaccination rate compared to the B group was 2.49 (95% confidence interval [CI], 0.55-11.34) for the B+Br group and 43.72 (95% CI, 11.52-165.96) for the B+Br+DR group.Conclusions: Among the available methods, we are thought to be more effective to add doctor's verbal recommendation in a clinical setting.