Pneumococcal Vaccination in Oncology Practice in Türkiye: Results of Patient and Physician Survey Studies

Abstract

Objective: Patients with cancer are at increased risk for invasive pneumococcal disease due to disease-related immunosuppression and systemic anticancer treatments. Although international infectious disease and oncology guidelines recommend pneumococcal vaccination for all patients with malignancies, real-world vaccination rates remain suboptimal. Data evaluating pneumococcal vaccination awareness and practices among oncology patients and medical oncologists in Türkiye are limited.

Methods: This cross-sectional, questionnaire-based survey study was conducted in Türkiye using 2 structured questionnaires administered to adult oncology patients and medical oncologists. The patient survey included 425 patients (≥18 years) undergoing active systemic anticancer treatment or follow-up, and the physician survey included 120 medical oncologists involved in routine oncology care. Questionnaires assessed pneumococcal vaccination status, awareness, recommendation practices, and perceived barriers. Descriptive statistics were used to summarize the data, and categorical variables were compared using the chi-square or Fisher’s exact test, as appropriate.

Results: Overall, 49 patients (11.5%) reported having received at least 1 pneumococcal vaccination. Most vaccinated patients received a single-dose 20-valent pneumococcal conjugate vaccine (PCV20). Higher educational level and a history of splenectomy were associated with increased vaccination uptake. Only 61 patients (14.4%) reported having received adequate information about pneumococcal vaccination from their physicians; however, 78.5% of unvaccinated patients stated that they would have accepted vaccination if sufficiently informed. Medical oncologists identified outpatient workload, limited consultation time, and vaccine cost as major barriers to routine vaccination recommendation, and vaccination was often perceived as necessary primarily in the presence of comorbidities.

Conclusion: Pneumococcal vaccination coverage among oncology patients in Türkiye remains low despite clear guideline recommendations and high patient willingness when adequately informed. Physician practices, healthcare system constraints, and misconceptions regarding vaccination indications persist. Interventions focusing on physician education, patient awareness, and simplified vaccination strategies such as single-dose PCV20 schedules may improve vaccination uptake in routine oncology practice.

Cite this article as: Özkerim U, Öksüz S. Pneumococcal vaccination in oncology practice in Türkiye: results of patient and physician survey studies. Cerrahpaşa Med J. 2026, 50, 0011, doi: 10.5152/cjm.2026.26011.