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Brief report: Risk factors for pneumococcal vaccine refusal in adults

A case-control study

  • Original Article
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Abstract

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 vacination (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.

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Authors and Affiliations

  1. Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Ga, USA

    Ekaterina V. Kourbatova MD, MPH, Sandy Goodman MPH & Susan M. Ray MD

  2. Atlanta VA Medical Center, Atlanta, Ga, USA

    Sandy Goodman MPH & Susan M. Ray MD

  3. Division of General Medicine, Emory University School of Medicine, 49 Jesse Hill Jr. Drive SE, 30303, Atlanta, GA

    Lesley S. Miller MD

Authors
  1. Lesley S. Miller MD
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  2. Ekaterina V. Kourbatova MD, MPH
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  3. Sandy Goodman MPH
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  4. Susan M. Ray MD
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Corresponding author

Correspondence to Lesley S. Miller MD.

Additional information

The authors of this manuscript report no conflicts of interest.

This work was supported in part by a grant from the National Vaccine Program and the CDC Emerging Infections Program.

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Miller, L.S., Kourbatova, E.V., Goodman, S. et al. Brief report: Risk factors for pneumococcal vaccine refusal in adults. J GEN INTERN MED 20, 650–652 (2005). https://doi.org/10.1111/j.1525-1497.2005.0118.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2005.0118.x

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