Metersky M L, Mennone J Z, Fine J M
Pulmonary Division, University of Connecticut School of Medicine, Farmington, USA.
Conn Med. 1998 Nov;62(11):649-54.
The pneumococcal polysaccharide vaccine (PPV) is effective in preventing invasive pneumococcal disease, but remains underutilized. Prior surveys of physicians revealed concern regarding the safety and efficacy of the vaccine, but there has been little information published in the last 10 years that sheds light on why the vaccine remains underutilized. Although there is currently emphasis on providing PPV to hospitalized patients, there is even less known about what factors prevent PPV use in the hospital setting and chronic care setting. We performed a survey of physicians in Connecticut to determine what factors prevent utilization of the vaccine in three patient care settings.
A survey of internists and family practitioners in Connecticut that ascertained their frequency of utilization of PPV and what factors inhibited utilization of PPV.
Three hundred ninety-seven responses are included in the analysis. Forgetting to administer the vaccine (59% of respondents) and patient refusal (55% of respondents) were the factors most frequently noted as being important in preventing vaccination in the outpatient setting. In the inpatient and chronic care settings, difficulty in determining the patient's vaccine status was also noted. Concerns regarding the efficacy or safety of the vaccine did not seem to be important. The factor that correlated most closely with the respondents' reported frequency of vaccine use was forgetting to vaccinate.
Physicians, although accepting the efficacy of PPV, are inhibited from its more frequent use by several factors.
肺炎球菌多糖疫苗（PPV）在预防侵袭性肺炎球菌疾病方面有效，但使用率仍然较低。此前对医生的调查显示他们对该疫苗的安全性和有效性存在担忧，但在过去10年里，几乎没有公开信息能阐明该疫苗使用率仍然较低的原因。尽管目前重点是为住院患者提供PPV，但对于在医院环境和长期护理环境中阻碍使用PPV的因素了解更少。我们对康涅狄格州的医生进行了一项调查，以确定在三种患者护理环境中阻碍该疫苗使用的因素。
对康涅狄格州的内科医生和家庭医生进行一项调查，确定他们使用PPV的频率以及哪些因素阻碍了PPV的使用。
分析纳入了397份回复。忘记接种疫苗（59%的受访者）和患者拒绝（55%的受访者）是门诊环境中预防接种时最常被指出的重要因素。在住院和长期护理环境中，确定患者疫苗接种状态困难也被提及。对疫苗有效性或安全性的担忧似乎并不重要。与受访者报告的疫苗使用频率相关性最密切的因素是忘记接种。
医生虽然认可PPV的有效性，但因多种因素而较少频繁使用该疫苗。
