Knowledge, Attitude, and Practice of Adult Pneumococcal Vaccination in India: A Prospective, Cross-sectional, Questionnaire-based Survey of Pediatricians.

BACKGROUND

The proportion of the elderly population in India is expected to double by the year 2050. Number of deaths because of lower respiratory tract infections (LRI) caused by are substantial in adults aged >70 years. Pneumococcal diseases are vaccine-preventable diseases (VPDs). Vaccination is safe, effective, and economical protection against infections. However, adult vaccination in India is uncommon. One way to increase it would be to educate the adults accompanying their family to vaccination visits, and improve the adult vaccination rates.

OBJECTIVE

In this cross-sectional study, we intend to assess the knowledge, attitude, and practice (KAP) of pediatricians to understand the barriers to pneumococcal vaccination in adults in India.

MATERIALS AND METHODS

The study was a descriptive, cross-sectional, questionnaire-based survey in which 650 pediatricians were invited to participate. The survey consisted of structured questions sent to the participants in Microsoft Form through emails. The responses were collected, analyzed, and compared for final interpretations using SPSS software.

RESULTS

Of the total 500 pediatricians who consented to study participation, one-third (39.6%) of pediatricians would recommend pneumococcal vaccination to adults >60 years accompanying the children, and 33.2% of the pediatricians reported that they vaccinate adults only when presented with a prescription or advised by the adult's treating physician. Most pediatricians (72.1%) reported that among their patients they would give the highest priority for pneumococcal vaccination in adolescents with chronic lung and heart diseases, and 70.4% of the pediatricians reported that only about one in five families (5-20%) consulting with them are aware of adult vaccination other than the COVID-19 vaccine. Pediatricians (80%) gave the highest priority to "low awareness regarding pneumococcal disease in adults," while only 30.4% of the pediatricians had taken the pneumococcal vaccination.

CONCLUSION

The study objectively identifies barriers to pneumococcal vaccination in adults in India from the pediatrician point of view. There is a lack of awareness among pediatricians about adult vaccination recommendations. National guidelines among pediatricians for adult vaccination, including data on vaccine safety, efficacy, and disease burden, would help pediatricians in counseling adults for vaccination. Per the pediatricians, patient-level barriers to vaccinations are poor awareness and understanding of both adult pneumococcal disease and vaccination, along with affordability.