A cross-sectional study to investigate pneumococcal vaccination in the elderly in a low income county: patient knowledge, awareness, and attitudes of vaccination and prevalence rates by socioeconomic status

Abstract

Background: Pneumonia represents the leading cause of infection-related death and the fifth cause of overall mortality, in the elderly. With increasing age, the human immune system undergoes characteristic changes which lead to increased incidence and severity of infectious diseases and to insufficient protection following vaccination as antibody response of elderly vaccines are weaker and decline faster.

Objective: Knowledge and Attitude toward Pneumonia and its Vaccination in elderly patients.

Result: Among low SES, 54.9% (549/1000) while from high SES, 91.8% (918) responded that they had heard about pneumonia before (P<0.05). 79.5% (795/1000) patients of high SES had heard about pneumococcal vaccination while only 28.8% (288/1000) patients from low SES had heard about pneumococcal vaccine. Only 2.3% of low SES patients were immunized for pneumococcal vaccine while 16.5% high SES patients were vaccinated. Reported reason for not being immunized were; did not hear, no body advised, vaccine is too expensive, and ignored thinking it is not necessary.

Method: We conducted a cross-sectional study on 2000 elderly patients who were admitted in medicine and surgery wards of Civil Hospital Karachi and Aga Khan University Hospital Karachi from the period of October to December 2012 to determine their knowledge and attitude toward pneumonia and its vaccination in elderly. Study group was divided into low and high socio-economic status on the basis of patients coming to government Hospital i.e., civil hospital and private hospital i.e., Aga khan hospital. Data was collected through convenient sampling technique. Exclusion criteria were patients below 60 years and those who didn't give consent to be part of study.

Conclusion: Aside from introducing public awareness program about elderly vaccination at state level, free of cost vaccination of elderly individuals should be done.

Keywords: bacteremia; fluoroquinolone; immunization; streptococcus pneumoniae; susceptibility.

Figure 1. Combined presentation of why not being vaccinated among low and high SES class.

Figure 2. Multiple response table to best course of action for pneumonia.