Research Projects (Third party funds)


Knowledge, attitude and practice regarding vaccination in the elderly population in Germany and among staff of General Practitioner practices (project concluded)

Vaccinations are an effective and save method to prevent infectious diseases. Official recommendations in Germany for persons aged 60 years and older include tetanus-, influenza- and pneumococcal-vaccination, but although costs are covered by the public health insurances, the uptake is relatively low.

To investigate the reasons for this, this project was conducted. Data from a representative survey obtained from the Federal Centre for Health Education were used and knowledge, attitudes and practices in the elderly regarding vaccinations were studied. Results implicate that the uptake and the barriers for getting vaccinated differ between the vaccines and that, therefore, specific interventions to increase uptake might be necessary for each vaccine. For the pneumococcal-vaccination, an increase in knowledge should be the main target, for the influenza-vaccination, the related attitudes should be tackled. Regarding the tetanus-vaccination, practices (e.g. possessing a vaccination-card) are most important. A main reason for not getting vaccinated was no recommendation by a physician or other medical and para-medical staff in charge. So, we initiated a second study to assess knowledge, attitude and practices regarding (not) advising vaccinations for the elderly among German General Practitioners (GP) and Physician Assistants (PA). About one fifth of the responding participants indicated to have not advised an officially recommended vaccination to elderly patients, mostly because it was forgotten. GP reported to recommend vaccines less often, but had better subjective knowledge than the PA. For advising most of the analyzed vaccinations, we found an association with not advising regularly on vaccinations. Based on these results, information on vaccinations for professionals should include information material specifically adjusted to the needs of PA, as well as a promotion of regular vaccination consultation and improved implementation of recall- and reminder systems.

PhD Student involved

Carolina Klett-Tammen (PhD Programme "Health related care for a self-determined life in old age - Theoretical concepts, users' needs and responsiveness of the health care system" - Niedersächsisches Ministerium für Wissenschaft und Kultur)



  • Federal Centre for Health Education (BzgA)
  • PD Dr. phil. Dipl.-Psych. Thomas von Lengerke, Hanover Medical School.


Klett-Tammen CJ, Krause G, Seefeld L, Ott JJ. Determinants of tetanus, pneumococcal and influenza vaccination in the elderly: A representative cross-sectional study on Knowledge, Attitude and Practice (KAP). BMC Public Health 2016; 16(1):121. DOI: 10.1186/s12889-016-2784-8

Klett-Tammen CJ, Krause G, von Lengerke T, Castell S. Advising vaccinations for the elderly: a cross-sectional survey on differences between general practitioners and physician assistants in Germany. BMC Fam Pract. 2016; 17(1):98. DOI: 10.1186/s12875-016-0502-3

Project Leaders

Dr. Stefanie Castell
Stellv. Abteilungsleiterin Epidemiologie und Wissenschaftliche Mitarbeiterin

Dr. Jördis J. Ott
Wissenschaftliche Mitarbeiterin



Funding agency

Ministry for Science and Culture of Lower Saxony

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