Family doctor advice is the main determinant of pneumococcal vaccine uptake.

Pneumococcal disease is an important cause of avoidable morbidity and mortality. In Britain the estimated annual incidences of pneumococcal pneumonia, bacteraemia and meningitis are 100/10, 7/10 and 0.5/10 respectively. 2 Population aging, and the growing problem of antibiotic resistant pneumococci make these problems of increasing public health importance. The current 23-valent pneumococcal vaccine covers 96% of all serious infections, and is recommended for patients with chronic pulmonary disease, heart disease, renal disease, liver disease, immunodeficiency and immunosuppression, asplenia and severe splenic dysfunction, and diabetes. However, uptake is believed to be low, with one recent survey suggesting that only 4% of those at risk had been covered. We conducted a study of hospitalised patients with definite indications for pneumococcal vaccine to identify factors involved in the receipt or non-receipt of vaccine.