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.
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.
Authors: Daniel A Salmon; William K Y Pan; Saad B Omer; Ann Marie Navar; Walter Orenstein; Edgar K Marcuse; James Taylor; M Patricia deHart; Shannon Stokley; Terrell Carter; Neal A Halsey Journal: Hum Vaccin Date: 2008-02-19
Authors: Robert McMurray; Francine M Cheater; Anna Weighall; Carolyn Nelson; Martin Schweiger; Suzanne Mukherjee Journal: Br J Gen Pract Date: 2004-07 Impact factor: 5.386
Authors: James J Cotter; J D Bramble; Viktor E Bovbjerg; Carol B Pugh; Donna K McClish; Gary Tipton; Wally R Smith Journal: J Natl Med Assoc Date: 2002-09 Impact factor: 1.798
Authors: Nancy D Lin; Ken Kleinman; K Arnold Chan; Xian-Jie Yu; Eric K France; Stanley Xu; Feifei Wei; John Mullooly; Jeanne Santoli; Tracy A Lieu Journal: BMC Pediatr Date: 2005-11-28 Impact factor: 2.125
Authors: Michelle J Mergler; Saad B Omer; William K Y Pan; Ann Marie Navar-Boggan; Walter Orenstein; Edgar K Marcuse; James Taylor; M Patricia deHart; Terrell C Carter; Anthony Damico; Neal Halsey; Daniel A Salmon Journal: Vaccines (Basel) Date: 2013-04-29