General practitioners’ perceptions on pneumococcal vaccination for children in United Kingdom

Abstract

Following the introduction of the pneumococcal conjugate vaccination program for children in the UK, a study of General Practitioners in Walsall and Liverpool was undertaken to identify the possible reasons for the delay in implementation of the program. A total of 143 GPs were contacted, of whom 39 responded (response rate = 27%). One-third of the GPs felt that there was 'delay' in the introduction of the program. The main reasons for possible delay in the implementation of the program were 'problems with databases', 'inadequate/unclear information from Primary Care Trust,' 'lack of public awareness' and 'parental delay.' Twelve percent of the respondents said that issue of 'payment' to them was the reason for not implementing the program. Most of the reasons given were 'external' to the practitioners. This being an initial exploratory study of its kind, the authors recommend that the results of this study be used in conjunction with other quantitative data by commissioners of health services in designing the implementation of a new vaccination program.

The burden of invasive pneumococcal disease in children with underlying risk factors in North America and Europe

“…It is noteworthy that PPV‐23 vaccination of children older than 2 years and at risk of IPD is recommended in some countries. Unfortunately, pneumococcal vaccination coverage in high‐risk children is relatively low compared with routine childhood vaccination with PCVs . For example, an Italian study in children with HIV infection, cystic fibrosis, liver transplantation or diabetes mellitus found that pneumococcal vaccination rates were below 25% in each group .…”

Association of infant pneumococcal vaccination with pneumococcal pneumonia among mothers: A nested case–control study using the GPRD

“…Second, we may have underestimated the prevalence of infant PCV7 vaccination, for example, if infants received a vaccine dose from a physician other than their own GP who may not have recorded their vaccine in the GPRD database. Importantly, since GPs are paid a small fee for each immunization that they administer, child immunization records in the UK are expected to be highly accurate [20]. Because vaccinations are given in primary care which is accessible to everyone, under-ascertainment of PCV7 immunizations would likely be random, and therefore expected to result in a bias toward the null.…”

“…The database captures nearly all episodes of pneumonia that are diagnosed and treated by general practitioners, require hospitalization, or result in death [16]. Also, infant immunizations are administered in general practices, and patient records describing receipt of immunizations have been found to be virtually complete [17][18][19][20]. This study was approved by the Independent Scientific Advisory Committee (ISAC) within the UK Medicines and Healthcare Products Regulatory Agency.…”

“…Ten control mothers without a history of any pneumonia and who had at least two years of complete medical history in the database were randomly selected from the same study population as the cases and matched to each case on index date of the case diagnosis, age, birth date of first child, current smoking status and presence or absence of chronic lung disease [20], as well as use of any benzodiazepine or anti-depressant medications [21]. We chose to match controls to cases on prior use of benzodiazepines or anti-depressants because more than half the cases in our study had been prescribed at least one of these medications, and because there is some evidence that the treated conditions may confer increased risk of pneumonia or may be a marker for health care consumption [21].…”

“…Mothers were classified as being exposed or unexposed based on the PVC7 immunization status of their first-born infant. Based on the recommended immunization schedule, mothers whose firstborn infants received three doses of PCV7 were considered exposed, and mothers who received fewer than three doses of PCV7 were considered not exposed [1,20]. PCV7 vaccination status in infants was ascertained using the following READ codes recorded in the GPRD: 657L.00, 657M.00, 657N.00, 6572.00, 6572000 or 900.00.…”