Haemophilus influenzae b polysaccharide vaccine. Physician acceptance and use of a new vaccine
S. L. Cochi, D. W. Fleming, H. F. Hull, S. R. Preblud and W. A. Orenstein
The introduction of Haemophilus Influenzae type b (Hib) polysaccharide
vaccine in 1985 provided an opportunity to study the extent to which
physicians have adopted the use of the new vaccine in their routine
practice behavior, the factors that predict Hib vaccine use by physicians,
and how physicians have chosen to deal with differing recommendations for
its administration. We surveyed all physicians providing primary care to
children in New Mexico six to eight months after vaccine licensure to
assess their knowledge of existing recommendations and their current
behavior regarding use of the Hib vaccine. Of the 369 primary care
physicians who responded, 100% of pediatricians, 98% of family
practitioners, and 91% of general practitioners were aware that a vaccine
against invasive Hib disease had been licensed. Sixty-three percent of
physicians surveyed were currently using the vaccine. Vaccine usage varied
significantly by specialty, with 86% of pediatricians reporting use
compared with 61% of family practitioners and 31% of general practitioners.
Physicians were significantly more likely to use Hib vaccine if they were
young and if they worked in the private sector rather than the public
sector. The three sets of recommendations for Hib vaccine use had been
widely read; 85% of respondents had read at least one set. Practitioners
confronted with differing recommendations had elected to give the vaccine
permissively within existing guidelines. Our findings suggest that
practitioners have adapted quickly to the introduction of Hib vaccine but
that nonuse of the vaccine in the public sector remains an obstacle to full
implementation of this prevention strategy.
