Physician Perspectives Regarding Pneumococcal Conjugate Vaccine

Abstract

ABSTRACT. Objectives. Pneumococcal conjugate vaccine (PCV) was first licensed for routine administration to young children in February 2000. The objective of this study was to assess physician perspectives about the use of PCV, to ascertain which children were being given the vaccine soon after licensure, and to determine how the addition of PCV to the schedule of recommended childhood vaccines may affect the timing of other vaccinations.Methods. A 30-item survey containing questions about the use of PCV was sent to all pediatricians and family physicians who provide primary care to young children in Monroe County (Rochester, NY) and Davidson County (Nashville, TN) in October 2000. As many as 3 subsequent mailings were sent to nonresponders. Descriptive and 2 statistical analyses and logistic regression were used to evaluate the responses.Results. Response rates were 82% in Rochester and 78% in Nashville. Eighty-two percent of responding physicians, including 92% of pediatricians and 55% of family physicians, indicated that they were giving PCV to their patients at the time of the survey. Sixty percent noted that an initial lack of insurance reimbursement for the cost of the vaccine caused them to delay introducing PCV. Fiftyone percent delayed initially offering the vaccine to any of their patients because the Vaccines for Children (VFC) program did not begin to offer PCV until several months later. The vast majority routinely vaccinated healthy children who are younger than 2 years as well as older children who had defined chronic medical conditions that put them at high risk of invasive pneumococcal disease. Fewer than 15% were recalling patients for PCV, with most recall efforts focused on patients who had chronic medical conditions. When discussing PCV with parents, 78% of physicians primarily emphasized the vaccine's potential to decrease the risk of sepsis and/or meningitis, whereas smaller percentages primarily emphasized the vaccine's potential to decrease the risk of pneumonia or ear infections. Approximately 20% of physicians who gave PCV delayed other vaccinations (primarily varicella vaccine, hepatitis B vaccine, or polio vaccine) because of concern about administering 4 or more vaccines simultaneously. Similarly, 40% of physicians indicated that they considered PCV to be more important than varicella vaccine or hepatitis B vaccine, whereas 26% percent considered PCV to be more important than polio vaccine.Conclusions. PCV has been widely accepted by physicians in both Rochester and Nashville. However, many physicians delayed introducing the vaccine for reasons that were ultimately related to financial considerations. For privately insured patients, delays were related to when coverage for PCV was added to benefit packages. For patients who receive publicly purchased vaccine via the VFC program, delays were related to availability of the vaccine through the VFC program. In addition, after the introduction of PCV, some physicians began delaying the administration of other vaccines because of the need...

Availability of Human Papillomavirus Vaccine at Medical Practices in an Area with Elevated Rates of Cervical Cancer

“…Although the number of pediatrics practices was relatively small in the study counties, we did not find that pediatricians were much more likely to carry HPV vaccine than family practitioners, as has been observed soon after introduction of several childhood vaccines [9][10][11]. Few internal medicine practices had the vaccine; however, 64% of obstetrics-gynecology practices offered it.…”

Adoption of Rotavirus Vaccine by U.S. Physicians

“…As with other studies on the adoption of new vaccines, [24][25][26] there were important differences between family medicine physicians and pediatricians in practices and attitudes regarding rotavirus vaccine. Although both specialties are more likely to administer rotavirus vaccine now than they were 5 years ago, pediatricians are substantially more likely to use the vaccine, report a higher level of confidence in the effectiveness of rotavirus vaccine, and feel favorable about the vaccine.…”

Knowledge of vaccination of allergic children among Italian primary care pediatricians, hospital pediatricians and pediatric residents

“…However, communicating the risks and benefits of vaccines does not always meet parents' needs because a number of pediatricians do not accept patients whose parents refuse vaccination, and pediatricians' knowledge of infant vaccination recommendations is generally quite poor [5]. Various studies have clearly demonstrated that, particularly when new vaccines are included in the immunization schedules recommended by health authorities, pediatricians do not always know the schedules themselves or the related contraindications and this may contribute towards increasing the number of missed opportunities to immunize [6][7][8][9][10][11].…”