You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT ARCHIVES
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 151 No. 7, July 1997 TABLE OF CONTENTS
  Archives
  •  Online Features
  ARTICLE
 This Article
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Contact me when this article is cited
 Related Content
 •Similar articles in this journal

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.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

How Do Physicians Immunize Their Own Children? Differences Among Pediatricians and Nonpediatricians
Posfay-Barbe et al.
Pediatrics 2005;116:e623-e633.
ABSTRACT | FULL TEXT  

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.
CLIN PEDIATR 2004;43:87-93.
ABSTRACT  

The Effect of Education, Feedback, and Provider Prompts on the Rate of Missed Vaccine Opportunities in a Community Health Center
Sabnis et al.
CLIN PEDIATR 2003;42:147-151.
ABSTRACT  

Paediatricians' misconceptions on childhood immunisations
Stathopulu
Arch. Dis. Child. 2002;87:264-264.
FULL TEXT  

Adolescent Immunization Practices: A National Survey of US Physicians
Schaffer et al.
Arch Pediatr Adolesc Med 2001;155:566-571.
ABSTRACT | FULL TEXT  

Variation in Clinician Recommendations for Multiple Injections During Adoption of Inactivated Polio Vaccine
Lieu et al.
Pediatrics 2001;107:e49-e49.
ABSTRACT | FULL TEXT  

Childhood Vaccine Risk/Benefit Communication in Private Practice Office Settings: A National Survey
Davis et al.
Pediatrics 2001;107:17e-17.
ABSTRACT | FULL TEXT  

Estimation of Neonatal Outcome and Perinatal Therapy Use
Morse et al.
Pediatrics 2000;105:1046-1050.
ABSTRACT | FULL TEXT  

Parental Compliance With Multiple Immunization Injections
Melman et al.
Arch Pediatr Adolesc Med 1999;153:1289-1291.
ABSTRACT | FULL TEXT  

Immunization Survey in Iowa
Golombek et al.
Arch Pediatr Adolesc Med 1998;152:208-209.
FULL TEXT  

Physician Concerns About Vaccine Adverse Effects and Potential Litigation
Zimmerman et al.
Arch Pediatr Adolesc Med 1998;152:12-19.
ABSTRACT | FULL TEXT  

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.
ABSTRACT | FULL TEXT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 1997 American Medical Association. All Rights Reserved.