A national survey to understand why physicians defer childhood immunizations
R. K. Zimmerman, J. J. Schlesselman, A. L. Baird and T. A. Mieczkowski
Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, PA, USA.
OBJECTIVE: To determine the causes of low childhood immunization rates
based on physicians' knowledge, attitudes, and self-reported practices
concerning childhood immunization. DESIGN: A standardized telephone survey
conducted by trained interviewers. SETTING: Primary care physicians across
the United States. PARTICIPANTS: A stratified random sample of office-based
family physicians, pediatricians, and general practitioners younger than 65
years was selected from the American Medical Association master file list
that includes nonmembers. Physicians seeing 5 or more patients per week
younger than 6 years and having 50% or more primary care patients were
eligible for study. Of 1769 eligible physicians who spoke directly with the
interviewers, 70% (N = 1241) completed the questionnaire. INTERVENTIONS:
The interview was designed to determine physicians' likelihood of
recommending vaccination in common clinical scenarios and to probe reasons
behind these decisions. RESULTS: Only 4% of physicians who thought the risk
for side effects was increased by upper respiratory tract infection (URI)
were likely to vaccinate a child with URI vs 55% of physicians who thought
there would be no increased risk (P < .001). Eighty-three percent of
those who thought the efficacy of measles, mumps, and rubella vaccine would
not be affected by a URI recommended vaccination vs only 8% of physicians
who thought efficacy would decrease (P < .001). Some respondents (11%)
would not administer 3 injectable vaccines simultaneously based on beliefs
about side effects, parental objections, and vaccine efficacy. Physicians'
likelihood of vaccination also varied by type of visit: 47% were less
likely to vaccinate a child with a URI in an acute care as opposed to a
well-child setting. CONCLUSION: Physicians' beliefs and practice policies
materially influence their likelihood of recommending vaccinations.
How Do Physicians Immunize Their Own Children? Differences Among Pediatricians and Nonpediatricians
Posfay-Barbe et al.
Pediatrics 2005;116:e623-e633.
ABSTRACT
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Clinician Satisfaction with Vaccination Visits and the Role of Multiple Injections, Results from the Covise Study (Combination Vaccines Impact on Satisfaction and Epidemiology)
Meyerhoff et al.
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ABSTRACT
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Sabnis et al.
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ABSTRACT
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Stathopulu
Arch. Dis. Child. 2002;87:264-264.
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Adolescent Immunization Practices: A National Survey of US Physicians
Schaffer et al.
Arch Pediatr Adolesc Med 2001;155:566-571.
ABSTRACT
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Variation in Clinician Recommendations for Multiple Injections During Adoption of Inactivated Polio Vaccine
Lieu et al.
Pediatrics 2001;107:e49-e49.
ABSTRACT
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Childhood Vaccine Risk/Benefit Communication in Private Practice Office Settings: A National Survey
Davis et al.
Pediatrics 2001;107:17e-17.
ABSTRACT
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Estimation of Neonatal Outcome and Perinatal Therapy Use
Morse et al.
Pediatrics 2000;105:1046-1050.
ABSTRACT
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Parental Compliance With Multiple Immunization Injections
Melman et al.
Arch Pediatr Adolesc Med 1999;153:1289-1291.
ABSTRACT
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Immunization Survey in Iowa
Golombek et al.
Arch Pediatr Adolesc Med 1998;152:208-209.
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Physician Concerns About Vaccine Adverse Effects and Potential Litigation
Zimmerman et al.
Arch Pediatr Adolesc Med 1998;152:12-19.
ABSTRACT
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Vapocoolant Spray Is Equally Effective as EMLA Cream in Reducing Immunization Pain in School-aged Children
Cohen Reis and Holubkov
Pediatrics 1997;100:e5-e5.
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