Doctor Knowledge Lacking in Prescribing Pneumococcal Vaccinations for Patients With Cardiovascular Disease


Nearly all of the doctors polled recommended the pneumococcal vaccine for patients with cardiovascular disease aged 65 years and older.

Doctor Knowledge Lacking in Prescribing Pneumococcal Vaccinations for Patients With Cardiovascular Disease

Dr. Naveed Ahmed Shaikh

There remains a dearth of knowledge, even among doctors, on the best reccomendations for patients with cardiovascular disease regarding the influenza and pneumococcal vaccines.

A team, led by Dr. Naveed Ahmed Shaikh, National Institute of Cardiovascular Diseases, evaluated the knowledge of cardiologists, internists, and family physicians on influenza and pneumococcal vaccinations among patients with cardiovascular disease.

The Survey

In the study, the investigators created an online survey sent out to practicing cardiologists, internists, and family physicians at various positions from tertiary health care centers of all major hospitals in Pakistan.

The aim of the questionnaire was to assess knowledge of influenza and pneumococcal vaccinations and some barriers that exist for prescribing it to the recommended patients with cardiovascular disease.

Doctor Knowledge

Overall, the study included 380 physician responders, 58.9% (n = 224) were male and 96.3% (n = 366) was aged at least 40 years. A total of 314 (82.6%) of participants endorsed the pneumococcal vaccine as a class I indication in cardiac patients older than 65 years. On the other hand, less than half (48.2%; n = 183) considered it to be recommended by the American College of Cardiology or the American Heart Association for all age groups of patients with cardiovascular disease.

There was also results on the knowledge of the actual vaccine.

For example, only 41.8% (n = 159) of the participants knew the pneumococcal vaccine was a live attenuated vaccine, with a mean knowledge score of 63.09 ± 13.61.


The most common reason for not prescribing the pneumococcal vaccine was that it was not readily available (42.9%; n = 42). This was followed by the perception that the vaccine was not indicated (36.7%; n = 36).

“Most of the physicians were not thoroughly well-aware about indications of the vaccine in CVD patients,” the authors wrote. “Additionally, scope of the vaccine is under-estimated because of lack of knowledge regarding importance of vaccine and secondly due to unavailability of vaccine in most of the areas of Pakistan.”

Pregnant Women and the Influenza Vaccine

Recently, investigators found vaccine uptake for influenza in pregnant women was enhanced through vaccine education, sufficient time for vaccine discussions with maternity health care professionals (MHCPs), electronic prompts about vaccination, and evidence based local and national guidelines.

While World Health Organization (WHO) recommends that pregnant women are vaccinated against the flu, uptake of the vaccine has remained low.

MHCPs play a significant role in influencing the decisions of pregnant women in relation to vaccination.

Despite this, MHCPs knowledge and beliefs regarding the flu vaccine, their experience supporting pregnant women, and their workload and time restrains can affect the uptake of vaccines in this vulnerable population.

The main takeaway was MHCPs believed that vaccine delivery could be facilitated through trusting relationships, good communication, knowledge about the vaccine leading to confidence in recommending vaccine, electronic prompts and national guidelines.


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