Missed opportunities to vaccinate a cohort of hospitalised elderly with pneumococcal and influenza vaccines

This study examines missed opportunities for recommended influenza vaccine and 23-valent pneumococcal vaccine (23vPPV) among hospitalised elderly persons. 4772 inpatients aged > or = 65 years (cases of pneumonia and frequency-matched randomly selected cohort subjects) participated from two large tertiary Australian hospitals. For subjects unvaccinated with influenza vaccine (past year), 1110/1115 (99.6 ) had visited either a doctor (99.4 , mean 11.2 visits) or the same hospital (52.0 , mean 1.5 visits). For those unvaccinated with 23vPPV (past 5 years), 1809/1813 (99.8 ) had visited either a doctor (99.7 , mean 11.2 visits) or the same hospital (51.5 , mean 1.5 times) in the past year; 71 had been admitted to the same hospital in the past 5 years (mean 3.4 times). 2.3 of all subjects had vaccination status recorded. No unvaccinated subject was vaccinated during admission, despite approximately 40 reporting acceptability of vaccination if offered. Previous hospitalisation was a risk factor for being unvaccinated. Barriers to implementation of current vaccination policy in the hospital setting require formal evaluation in Australia.