Investigators from the University of Ottawa conducted a study to assess current pneumococcal immunization practices among health care workers and to identify capability, opportunity, and motivation factors regarding vaccination for older adult patients. Data for the mixed-methods systematic review was gathered from a search of MEDLINE, Embase, CINAHL, AgeLine, Global Health, and Scopus databases for studies published to November 2023.
The review included 42 studies, most of which were of cross-sectional design. Of the studies, 18 were conducted in North America, 13 in Europe, 10 in Asia, and 1 was conducted in multiple European countries. Most of the studies were conducted among general or family physicians in primary care settings.
What You Need to Know
While childhood pneumococcal vaccination helps reduce overall disease through herd immunity, it does not adequately protect older adults—especially those with chronic conditions—who remain highly vulnerable to severe infections like pneumonia and meningitis.
Most healthcare providers are well-informed and supportive of pneumococcal vaccination for older adults, but face significant challenges in practice.
Common barriers include vaccine cost, unclear guidelines, time constraints, supply issues, and incomplete vaccination histories.
The study found that health care worker practices around pneumococcal vaccination for older adult patients varied widely. Reported rates of administering or recommending the vaccine to elderly patients ranged from 23.7% to 100%. However, one study found that 78% said they prescribe the vaccine throughout the year. Some health care workers said they recommended pneumococcal vaccines more actively to patients 65 years of age and older compared to those 50 years and older with or without underlying chronic diseases. Most health care workers were seen to be knowledgeable and aware of pneumococcal vaccination.
Barriers to pneumococcal vaccination reported by health care workers included high costs to the patient and systems, inadequate reimbursement, unclear guidelines and recommendations, logistical barriers such as insufficient time, inconsistent vaccine supply, and unclear patient vaccination history. Additionally, 80% to 87% of providers said that a clear policy on vaccination would likely increase coverage.
“To improve vaccine uptake, tailored education, clearer guidelines, adequate consultation time, better integration with other health services, and financial support are essential,” the study authors concluded. “Enhancing healthcare workers' capacity and motivation through education, addressing misinformation, and providing incentives can further improve pneumococcal vaccination rates among older adults.”
References
1. Akther A, Laurie C, Elton-Marshall T, et al. Healthcare workers' current practices, knowledge/awareness, barriers, and attitudes/perceptions related to pneumococcal vaccination of older adults: A mixed-methods systematic review. Vaccine. August 2025. https://doi.org/10.1016/j.vaccine.2025.127331
2. Kobayashi M, Leidner AJ, Gierke R, et al. Expanded Recommendations for Use of Pneumococcal Conjugate Vaccines Among Adults Aged ≥50 Years: Recommendations of the Advisory Committee on Immunization Practices — United States, 2024. MMWR Morb Mortal Wkly Rep 2025;74:1–8. DOI: http://dx.doi.org/10.15585/mmwr.mm7401a1.
