The vaccination uptake rate is consistently low in Hong Kong. In order to examine the attitudes among doctors in the private sector towards pneumococcal vaccines, and the motivations and barriers of advising patients to vaccinate, the Hong Kong Medical Association has commissioned the Centre for Health Education and Health Promotion of the Jockey Club School of Public Health and Primary Care of the Faculty of Medicine of the Chinese University of Hong Kong, to conduct a cross sectional study on attitudes among general practitioners towards pneumococcal vaccination for adults in Hong Kong, and identify factors affecting their decision to advise pneumococcal vaccination for those age groups.
858 general practitioners in private practice returned the questionnaire and their average year in clinical practice was reported to be 32 years. The locations of their clinics are distributed in different parts of Hong Kong. Over 50% of the respondents would recommend pneumococcal vaccination for the elderly (age 65+) but less than 20% would do so for the middle-aged (age 50-64). The main reasons given were consultation not related to vaccine, pneumonia uncommon in their daily practice (nearly 70% of respondents attending five or less patients with pneumonia each year), and low perception of severity about pneumonia by patients. If General Practitioners (GPs) would get vaccination when reaching age 50, and attending more pneumonia cases in general practice were found to be factors associated with increasing likelihood of pneumococcal vaccine recommendation to both the middle-aged and the elderly. Participation in EVSS and patient concerned with safety were found to be factors associated with vaccine recommendation for the elderly only. Concerns of marketing a product and consultation not related to vaccination were factors associated with decreasing likelihood of recommending vaccination. Over 90% of the respondents expressed that the Government should promote severity of pneumonia as part of its pneumococcal vaccination promotion, and over 80% felt that Government should increase subsidy for EVSS.
Professor Albert LEE, Director of Centre for Health Education and Health Promotion of the Jockey Club School of Public Health and Primary Care of the Chinese University of Hong Kong said, "Doctors in primary care play an important role in motivating patients to adopt preventive health services such as vaccination to prevent infectious diseases. Efforts are needed to increase the epidemiologic data on the pneumococcal vaccination available to both GPs and public. Public policy is also needed to increase the awareness and impact of pneumococcal pneumonia and the availability of preventive measures. Those measures would remove the barriers and facilitate general practitioners in recommending pneumococcal vaccine to their patients."
Dr. Alvin Y. S. CHAN, Vice President of the Hong Kong Medical Association said, "This study has shown that it is important for the Government to set up a policy on Health Prevention in engaging our doctors in primary care in preventive medicine such as recommending vaccination for appropriate age groups." Dr. CHAN emphasized that the HKMA always encourages doctors for continuing medical education and advises the Government to increase the subsidy for various vaccination programs and develop preventive medicine. Last year, the Government adopted our advice by increasing the subsidy for childhood pneumococcal vaccination (from $80 to $130). The HKMA would continue to advise the Government to place importance on the adult preventive medicine and health education, e.g. to lower the age level of recipients of pneumococcal vaccination subsidy to aged 50, do more effective public education, and subsidize effective vaccination, so as to provide options for the patients. The Government should put forth effort to promote public-private interface on pneumococcal vaccination program.
Notes to editors:
The Hong Kong Medical Association, founded in 1920, aims to bring together