Pneumococcal vaccine campaign based in general practice.

OBJECTIVE: To show whether a general practice setting is a practical and effective medium for increasing uptake of pneumococcal vaccine. DESIGN: Follow up study of responses of general practices (debriefing by questionnaire or small group session) and patients (questionnaire sent to 429 patients vaccinated in a two week period) to vaccination campaign. SETTING AND SUBJECTS: Patients registered with general practices of one family health services authority. INTERVENTIONS: Pneumococcal vaccination campaign including clinical guidelines and support materials. MAIN OUTCOME MEASURES: Proportion of general practitioners offering pneumococcal vaccine; proportion of patients at risk who were vaccinated between 1 May and 31 December 1995; number of splenectomised patients identified and vaccinated in same period; views of patients who were vaccinated. RESULTS: Proportion of general practitioners offering pneumococcal vaccine increased from 17% to 89% during the campaign. Estimated number of patients at risk who were vaccinated increased from 656 (4%) to 5982 (33%) during campaign. Of 61 splenectomised patients identified, 30 had been vaccinated previously and 27 were vaccinated during campaign. Practices in which a general practitioner took or shared the lead had higher vaccination rates and used vaccine up faster. Of the 384 patients whose questionnaires were used in analysis, only 35 had heard of pneumococcal vaccine before the campaign, 198 reported side effects (mostly minor and local, but systemic and severe local reactions were more common than expected), and 337 were pleased they had been vaccinated (only five expressed dissatisfaction). CONCLUSION: A practice based campaign is an effective method of increasing uptake of pneumococcal vaccine by high risk groups.