Why is vaccination frequency low in elderly patients?

Abstract

Aim: The aim of the study is to investigate the frequency of vaccination in elderly outpatients, the reasons for not vaccinating despite vaccination recommendations and the related factors. Material and Method: The prospective study was done between June 2013-March 2015 and included patients who applied to the outpatient clinic for the first time, regularly attended to the controls and had at least 1 year of follow-up. Vaccination education was given to patients. At final assessment, the patients were interviewed by telephone. Vaccinations of all patients and why non-vaccinated patients were not vaccinated were questioned. All data were analyzed using appropriate statistical methods. Results: Of 267 patients enrolled in the study, mean age was 77±7.1 and mean follow-up period was 19.7±5.5 (month)were. At the end of follow-up, vaccination rates were: pneumococcal vaccine (PV) 21%, Influenza (IV) 35%, and tetanus-diphtheria (TdV) 8%. PV was found in a statistically significant relation between, IV (r=0.63, p<0.001), TdV (r=0.28, p<0.001), the inadequacy of information given by the physician and/or physician not telling to definitely do it (r=-0.43, p<0.001) and no previous vaccination recommendation (r=0.12, p=0.05). IV was found in a statistically significant relation between, PV (r=0.63, p<0.001), TdV (r=0.21, p<0.001), the inadequacy of information given by the physician and/or physician not telling to definitely do it (r=-0.46, p<0.001) and despite vaccination education missing to be vaccinated (r=0.20, p=0.01). Discussin: Vaccination frequency in elderly patients is lower than expected, although they are recommended to be vaccinated. The most common reason is the inadequacy of information given by the physician and/or physician not telling to definitely do it.

A review of factors influencing vaccination policies and programs for older adults globally

“… 40 Another Turkish study found that in the year following a GP vaccination recommendation for pneumococcal (6% to 21%, p < .001), influenza (18% to 35%, p < .001), and Tdap (5% to 8%, p = .21) vaccination rates rose among adults ≥65 years old. 41 Surveys in Japan and China also found a correlation between provider recommendation and vaccination among older adults for pneumococcal (age ≥60, OR = 8.50, p < .001) 42 and influenza (age ≥65, OR = 2.647, p < .010) vaccinations, respectively. 43 Expanding vaccination clinics with a physician recommendation further increased VCR.…”

Vaccination Rates in Geriatric Outpatient Clinic in Gaziantep Dr. Ersin Arslan Training and Research Hospital

“…Daha evvel Cerrahpaşa Tıp Fakültesi'nde yapılmış olan benzer çalışmada bu oranların influenza için %18, pnömokok aşısı için %6 ve DbT için %5 olduğu görülmüştür (6). Çalışmamızda artı olarak herpes zoster aşılanma durumu da sorgulanmıştır.…”

“…Bunun nedeni bölgemizde yaşayan ve polikliniğimize başvuran hastaların sosyo kültürel ve sosyo-ekonomik düzeyinin ve aşı bilincinin daha düşük olması olabilir. Literatürde ülkemizde yaşlılarda düşük aşılanma oranlarının olası nedenleri aşının etkinliğine inanmama, parasal nedenler, sağlık çalışanlarının aşılanma konusundaki bilgi eksikliği veya bu konuda gereken ısrarı göstermemesi, kurumsal desteklerdeki yetersizlikler olarak belirtilmiştir (5,6,8). PCV13 ve herpes zoster aşılarının ülkemizde sosyal güvenlik kurumu tarafından geri ödemesi bulunmamaktadır.…”