Objectives: To determine what proportion of eligible patients, when referred to a primary care physician for pneumococcal vaccination with a prescription, actually obtain the vaccination. To ascertain the number of eligible patients who would receive the vaccination in the emergency department (ED), if available.
Methods: The authors surveyed a convenience sample of patients presenting to an urban ED during a four-month period. Eligible patients were referred to specific sites with a prescription to be immunized. Data on those referred were collected by review of medical record and telephone follow-up.
Results: A total of 2,299 surveys were distributed; 338 patients declined to participate, yielding an 85% response rate. The total number of patients identified as having an indication for the pneumovax was 711 (36%). Of these, 411 were not previously vaccinated; 167 of the 411 had a contraindication to vaccination. The remaining 244 qualified for referral to receive the pneumococcal vaccine. One hundred thirty-one of these accepted referral prescription. Of the patients given prescriptions, 12 followed up and received the vaccine, 81 did not follow up, and 38 were lost to follow-up. Seventy-four percent of patients would have received the pneumovax in the ED if it had been available.
Conclusions: The percentage of ED patients who used prescription referral to the primary care network for pneumococcal vaccination was approximately 10%. The use of a referral by prescription method in this setting was not a reliable means of increasing the number of patients receiving the pneumococcal vaccination.