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Updated: Apr 13, 2026
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Published on: February 15, 2013
Evaluation of a nurse-led pneumococcal vaccination program in a day hospital
Olivier Bory1,2, Manon Verstraeten3, Elisabeth Aslangul3
1Service de médecine interne, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris, 178 rue des Renouillers, Colombes, 92700, France. olivier.bory@aphp.fr.
Insights
A nurse-led vaccination program significantly boosted pneumococcal vaccination rates in French adults. Most patients accepted the vaccine after brief counseling, demonstrating program feasibility.
Area of Science:
- Public Health
- Vaccinology
- Geriatric Medicine
Background:
- Pneumococcal vaccination coverage among at-risk adults in France is low.
- A nurse-led vaccination program was implemented in a French university hospital day-hospital.
- The study aimed to assess vaccination coverage, reasons for refusal, and program feasibility.
Purpose of the Study:
- To evaluate the impact of a nurse-led program on pneumococcal vaccination coverage.
- To identify factors associated with vaccine acceptance in at-risk adults.
- To assess the feasibility of a nurse-led vaccination strategy in routine care.
Main Methods:
- Retrospective observational study using health records from a day-hospital unit.
- Systematic offering of pneumococcal vaccination to unvaccinated patients over a three-week period.
- Multivariable penalized logistic regression to analyze factors associated with vaccine acceptance.
Main Results:
- Pneumococcal vaccination coverage increased from 39% to 79% after program implementation.
- Older age and male sex were associated with higher vaccine acceptance.
- Most accepted vaccinations (61%) were completed within 5 minutes of counseling.
Conclusions:
- A nurse-led program substantially increased pneumococcal vaccination coverage in a day-hospital setting.
- The program demonstrated feasibility for routine care, with efficient nurse intervention times.
- Barriers to vaccination included lack of knowledge and concerns about side effects, often linked to COVID-19.
Background:
Pneumococcal vaccination coverage among at-risk adults remains low in France. Our objectives were to assess pneumococcal vaccination coverage before and after implementation of a nurse-led vaccination program in a French university hospital day-hospital, to describe reasons for refusal, and to assess the duration of the nurse intervention as an indicator of feasibility in routine practice.
Methods:
We conducted a retrospective observational study using health records from the day-hospital unit where pneumococcal vaccination was systematically offered to unvaccinated patients during a three-week period in 2023. The nurse-led program encompassed identification of vaccination indications, patient counseling on vaccination, and immediate on-site vaccine administration when accepted. Multivariable penalized logistic regression was used to study factors associated with vaccine acceptance.
Results:
A total of 102 patients were analyzed (median age, 68 years [56-75]; 66% women). At baseline, pneumococcal vaccination coverage was 39%. Among unvaccinated patients (n = 62), two-thirds accepted vaccination, increasing overall coverage to 79%. Patients who accepted vaccination were older (aOR per 10-year increase, 1.98; 95% CI, 1.15-3.87) and more frequently male (aOR, 15.4; 95% CI, 1.6-501). Counseling duration was shorter among patients who accepted vaccination, with 61% completing the interview in less than 5 min. The most common reasons for refusal were insufficient knowledge and concerns about side effects, nearly half explicitly referring to COVID-19.
Conclusion:
A nurse-led program for pneumococcal vaccination in a day-hospital substantially increased vaccination coverage, with most accepted vaccinations completed within 5 min, supporting the feasibility of this strategy in routine care.
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