1. United to Prevent Pneumococcal Disease Public Health Advocacy Facilitators: Craig Roberts María L. Avila-Agüero Jorge LaRotta Gustavo Zabert 1

2. United to Prevent Pneumococcal Disease Objective: Prepare participants to engage in broad vaccine advocacy activities beyond their encounters with patients and their families Methods: Participants considered the systemic obstacles to vaccination that they would most like to address Groups self-divided into 4 groups for poster-facilitated discussions of: – Lack of societal awareness – HCP inaction – Cost-effectiveness – Practical impediments to vaccination Groups formed consensus recommendations for actions that physicians can implement to help eliminate these barriers to vaccination Workshop: Public Health Advocacy (Facilitators: Craig Roberts, Maria Luisa Ávila, Jorge LaRotta, Gustavo Zabert)

3. United to Prevent Pneumococcal Disease 3 Public Health Advocacy Workshop: Poster 1 of 4

4. United to Prevent Pneumococcal Disease 4 Public Health Advocacy Workshop: Poster 2 of 4

5. United to Prevent Pneumococcal Disease 5 Public Health Advocacy Workshop: Poster 3 of 4

6. United to Prevent Pneumococcal Disease 6 Public Health Advocacy Workshop: Poster 4 of 4

7. Public Health Advocacy: Workshop Discussions 7 Application of MDS Recommendations to public health with a national policy Technical ad board committee can involve applicable members to decision Deliver information to MDs in the public sector Education of the public is important, and society needs to value vaccinations Correct vaccine misinformation in the public sector Provide more education to the public and HCPs on the risk and burden of pneumonia Provide PD mortality statistics within context of more familiar causes of death, such as MI and cancer Encourage family vaccination A big campaign on vaccination in adults is needed; look to pandemic flu as an example Need to increase places for vaccination, and ensure there are more vaccination centers HCP Inaction

8. Public Health Advocacy: Workshop Discussions 8 Need to change people’s perception of vaccines; they are not just for kids Encourage prevention for the family Avoid scaring people into vaccination Maximize interest related to pandemic and other relevant news Develop standing orders Address resource limitations Promote social models Involve public HCPs Collect and share social data Show pharmacoeconomic benefits related to indirect and social costs Lack of Societal Awareness Cost-Effectiveness

9. Public Health Advocacy: Workshop Discussions 9 Improve infrastructure – Health insurance does not cover the vaccine – Many offices lack refrigeration Need recommendations for public health policy – Preventing absenteeism is a good promotion for vaccination Need MOHs and Societies to get involved HCPs share information on personal wellness with patients Equip medical personal with tools Surveillance programs will be very important Programs and national campaigns are needed – Accessibility and attention CME is needed Utilize the pediatricians – Adults do not expect an intervention talk at a peds visit – Equity – Cost to user Distribution and access is very important Must justify the expense of refrigeration for adult physicians Practical Impediments