New Combined Tetanus-Diptheria-Acellular Pertussis Vaccines for Adults: Primary Care Physician Attitudes and Preferences

Abstract

Availability of combined tetanus-diphtheria-acellular pertussis (Tdap) vaccines for adults offers a new pertussis prevention strategy for the US. Successful uptake of Tdap vaccine will depend partly on the attitudes and practices of primary care physicians, including their experience with Td boosters. We conducted a mail survey in August 2005 of a national random sample of 399 family physicians (FPs) and 399 general internists (IMs) to assess practices related to Td boosters, clinical experience with pertussis, and attitudes toward a potential Tdap vaccine recommendation for adults. The response rate was 49% (52% FPs, 46% IMs). Among 336 eligible respondents, half reported having clinical experience with pertussis. Most (81%) would recommend Tdap vaccine for their adult patients, and 73% support targeting adults likely to come in close contact with infants. Attitudes toward a potential Tdap vaccine recommendation differed by whether providers stock and administer Td boosters. We conclude that adult primary care providers in the US are likely to recommend Tdap vaccine to their adult patients, in concordance with recent national recommendations. Future research should assess the extent to which barriers impede adoption of Tdap vaccine recommendations.

Is patient insurance type related to physician recommendation, administration and referral for adult vaccination? A survey of US physicians

“…Findings from this survey provide contemporary context and evidence on the importance of understanding current physician attitudes, knowledge, practices and perceived barriers to adult vaccinations in the US. The results are consistent with prior research indicating that physician knowledge, attitudes and preferences influence their decisions about whether to offer or recommend vaccinations to adult patients and that cost, lack of tracking systems, and competing demands are barriers that affect access to immunizations among adults 4,[6][7][8][9][10][11][12][14][15][16][17][18][19]26 . Although a recent study from 2016 has explored physician attitudes regarding the perceived importance of vaccines and physician knowledge of ACIP recommendations, 26 to our knowledge studies have yet to explore physician practices in the context of Medicare versus commercial insurance coverage.…”

“…4,5 Knowledge, attitudes and practices of physicians play a critical role in vaccine uptake as shown in studies conducted between 1982 and 2010. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] Health insurance status and coverage further contribute to disparities in adult vaccination. 20 This is of particular interest given the recent policy changes in the US (e.g.…”

Pertussis vaccine for adults: Knowledge, attitudes, and vaccine receipt among adults with children in the household

“…However, no such requirement exists for adults, thus resulting in the reliance of subject vaccine recall. More importantly, the lack of access to accurate immunization records is a well-known barrier to adult vaccine completion [30][31][32]. Documentation of vaccine administration for adults into electronic immunization registries would eliminate the need to rely on vaccine recall and allow providers to have access to accurate vaccine documentation and to administer the recommended vaccines to the adult population.…”

Predictors of Tetanus–Diphtheria– Acellular Pertussis Vaccination Among Adults Receiving Tetanus Vaccine in the United States

“…Provider barriers might include doubt regarding the seriousness of pertussis and lack of knowledge about immunization guidelines. 21,22 These barriers reduce the likelihood of provider recommendation, which influences patients’ decisions regarding vaccination. 11,22,23 Providers may also miss opportunities to vaccinate because of competing demands, which could explain why respondents in this study were not more likely to receive pertussis vaccination with 10 or more yearly office visits.…”

“…The potential predictor variables were chosen based on studies suggesting that barriers to vaccination are often related to sociodemographics, utilization of health care services, health status, and an individuals' preventive behavior. [13][14][15][16] Sociodemographic variables included age (18)(19)(20)(21)(22)(23)(24), and 50-64 years), race-ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, other), gender, language (English, non-English), US census region, dependent children <18 years old (yes/ no), marital status (married, not married), education level (high school or less vs more than high school), employment status (employed vs unemployed), and total family income level (<$35 000, $35 000 up to $74 999, $75 000 up to $99 999, and ≥$100 000).…”