KEYWORDS:
Hepatitis A, Pneumococcal conjugate vaccine, vaccine uptake, practice assessment, provider attitudes and beliefs

BACKGROUND:
The rate of new vaccine development has increased dramatically in the past decade. Several new vaccines or new vaccine recommendations are likely to impact the healthcare industry now and in the future. These include new recommendations for the use of HAV and PCV7.

OBJECTIVE(S):
As part of the UCSD Partnership of Immunization Providers project, a study was conducted to measure the uptake of HAV and PCV7 and evaluate the factors that affect their use in 10 urban practices in San Diego County.

METHOD(S):
Forty-five providers from a convenience sample of 10 community clinics and private practices were selected for study. Serial chart audits were performed to examine missed opportunities (MO) of both vaccines as a measure of vaccine uptake. Questionnaires designed to evaluate beliefs and contributing factors to the administration of HAV and PCV7 were completed by all providers.

RESULT(S):
Providers missed more opportunities to deliver HAV compared to PCV7. Within the first four months following ACIP recommendations the MO rate for HAV was 97.3% compared to 64.1% for PCV7. After one year, the MO rate was 71.1% (HAV) and 46.7% (PCV7). Finding opportunities to deliver HAV correlated significantly with MO (-.321, p<.05). Cost, disease severity, vaccine effectiveness, and local incidence of disease did not significantly correlate with MO.

CONCLUSIONS(S):
There was a difference in the rate of uptake between PCV7 and HAV following ACIP recommendation. Provider experience with each disease may influence attitudes towards vaccine usage.

LEARNING OBJECTIVES:
Describe the uptake of HAV and PCV7 vaccines and the implications for intervention.