Reactions of Pediatricians to the Recommendation for Universal Varicella Vaccination

Abstract

Main Outcome Measure: Logistic regression was used to identify demographic characteristics, attitudes about varicella vaccine, and previous experiences with the disease that were associated with self-reported adherence to universal varicella immunization recommendations. Results: Completed surveys were returned by 76% of contacted pediatricians, of whom 42% reported following a policy of universal varicella immunization. In multivariate analysis, agreement with statements regarding the effectiveness of varicella vaccine in reducing rare but serious complications of the disease (odds ratio [OR], 4.90; 95% confidence interval [CI], 2.30-10.50) and in decreasing work loss by parents (OR, 4.21; 95% CI, 1.14-15.50) were associated with recommending universal immunization. Disagreement with statements concerning the lack of the need for varicella immunization because complications are rare (OR, 2.54; 95% CI, 1.12-5.74), it is not required for school entry (OR, 2.52; 95% CI, 1.37-4.64), and it is not medically cost-effective (OR, 2.25; 95% CI, 1.21-4.18) were also associated with universally recommending the vaccine. In addition, experience with varicella encephalitis was also associated with adherence to the recommendations (OR, 1.96; 95% CI, 1.06-3.65). Conversely, those who were concerned that varicella vaccine might not provide lifelong immunity were less likely to report recommending universal vaccination (OR, 0.36; 95% CI, 0.19-0.68). Conclusions: Fewer than 50% of responding Washington State pediatricians reported recommending universal varicella vaccination. Adherence to the recommendations appears to be influenced by personal experience, perceptions about the potential seriousness of varicella, and beliefs about the societal and medical costeffectiveness of varicella vaccine.

Barriers to Adolescent Immunization: A Survey of Family Physicians and Pediatricians

“…In addition, previous studies indicate that physicians are concerned that varicella may shift from being a childhood disease to primarily an adult disease, where the complications are greater. 10,[12][13][14][15][16] To the best of our knowledge, only one previous survey has been conducted assessing physician practices with regard to adolescent immuniza- tion. 17 Our survey sample was randomly selected and national in scope, surveying physicians in 28 states and the District of Columbia.…”

One-Year Uptake of Pneumococcal Conjugate Vaccine: A National Survey of Family Physicians and Pediatricians

“…15 In contrast, pediatrician incorporation of varicella vaccine into practice within 1 to 2 years in a Washington state sample was only 44%. 24 Although childhood vaccination rates are affected by multiple factors including family and health system issues as well as physician behaviors, 25,26 physician adoption of national recommendations is essential to the success of immunization initiatives. Recent data indicate a clear link between early physician incorporation of vaccines into routine practice and subsequent achievement of national immunization goals.…”

Attitudes and practices regarding varicella vaccination among physicians in Minnesota: implications for public health and provider education

“…Other surveys focused on pediatricians have produced similar findings. [12][13][14] Unique findings from this survey include the following. First, among a representative statewide sample of physicians, we found significant differences in vaccine acceptance between family physicians and pediatricians.…”

“…12 Information in the database includes scores on a standardized measure of basic daily living skills, the Functional Independence Measure, demographic variables, facility characteristics, diagnoses (International Classification of Diseases, Ninth Revision [ICD-9], codes), and LOS. 13 Detailed…”