Pneumococcal vaccine campaign based in general practice

BMJ 1997;314:1094 (12 April)

General practice

Pneumococcal vaccine campaign based in general practice

Paula McDonald, senior registrar in public health,^a E H I Friedman, director of public health,^a A Banks, medical adviser,^a Ros Anderson, pharmaceutical adviser,^a Val Carman, nurse adviser ^a

^a West Pennine Health Authority, Westhulme Avenue, Oldham OL1 2PL

Correspondence to: Dr P McDonald Communicable Disease Unit, PHL, Countess of Chester Health Park, Chester CH2 1UL

Objective:To show whether a general practice setting is a practicaland effective medium for increasing uptake of pneumococcal vaccine.
Design:Follow up study of responses of general practices (debriefingby questionnaire or small group session) and patients (questionnairesent to 429 patients vaccinated in a two week period) to vaccinationcampaign.
Setting and subjects:Patients registered with general practicesof one family health services authority.
Interventions:Pneumococcal vaccination campaign including clinicalguidelines and support materials.
Main outcome measures:Proportion of general practitioners offeringpneumococcal vaccine; proportion of patients at risk who werevaccinated between 1 May and 31 December 1995; number of splenectomisedpatients identified and vaccinated in same period; views ofpatients who were vaccinated.
Results:Proportion of general practitioners offering pneumococcalvaccine increased from 17% to 89% during the campaign. Estimated numberof patients at risk who were vaccinated increased from 656 (4%)to 5982 (33%) during campaign. Of 61 splenectomised patientsidentified, 30 had been vaccinated previously and 27 were vaccinatedduring campaign. Practices in which a general practitioner tookor shared the lead had higher vaccination rates and used vaccineup faster. Of the 384 patients whose questionnaires were usedin analysis, only 35 had heard of pneumococcal vaccine beforethe campaign, 198 reported side effects (mostly minor and local,but systemic and severe local reactions were more common thanexpected), and 337 were pleased they had been vaccinated (onlyfive expressed dissatisfaction).
Conclusion:A practice based campaign is an effective methodof increasing uptake of pneumococcal vaccine by high risk groups.

Key messages

Pneumococcal infections are an important cause of preventable morbidity and mortality
We set up a pneumococcal vaccination campaign based in the 37 general practices of Tameside family health services authority
The proportion of patients thought to be at risk who were vaccinated increased ninefold after the campaign started
Patients' prior awareness of the vaccine was low, and publicity was needed
Side effects from the vaccine were commonly reported, but most were minor and were well tolerated
This is an appropriate and effective method of increasing vaccine coverage among people at risk of pneumococcal infection

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