Adult pneumococcal vaccination in Northeast Nigeria: Insights into physicians’ knowledge, attitudes, and clinical practices

Abstract

Introduction: Streptococcus pneumoniae is a major cause of lower respiratory tract infections, invasive pneumococcal diseases (IPDs), and rising antibiotic resistance. Although adult pneumococcal vaccination is an effective preventive strategy, its uptake in Nigeria—especially in the Northeast—remains low. Physicians play a critical role in promoting vaccine uptake, yet data on their knowledge, attitudes, and practices (KAP) are limited. We assessed the physicians’ KAP regarding adult pneumococcal vaccination in Northeast Nigeria and identified barriers to inform strategies for improved uptake. Methods: A cross-sectional descriptive study was conducted among 73 physicians across all healthcare levels in Northeast Nigeria using a self-administered electronic questionnaire. Data were analysed with SPSS v26. Knowledge was assessed based on awareness of vaccine types, target groups, and guidelines; attitude on perceived importance and prescribing confidence; and practice on prescription behaviours and influencing factors. Results: Most respondents (60.3%) were aged 30–39 years and worked as general practitioners (38.3%) or internists (20.6%). Only 5.5% had received formal training on adult pneumococcal vaccination, and 34.2% were unaware of any pneumococcal vaccine. Just 9.6% correctly identified all high-risk adult groups. Although 79.5% viewed the vaccine as important, prescription rates were low. Key barriers included lack of training, poor guideline dissemination, limited vaccine access, and misconceptions about eligible populations. Conclusion: Despite favourable attitudes, significant knowledge and practice gaps exist among physicians. Targeted training, clearer national guidelines, and improved vaccine availability are essential to enhance adult vaccination rates and reduce the burden of pneumococcal disease in Northeast Nigeria.