KEYWORDS:
Varicella vaccine, immunization, provider attitudes

BACKGROUND:
Varicella vaccine has been available for use in Washington State since May 1995 free of charge to immunization providers through the Vaccines for Children (VFC) program. Despite the availability of free vaccine, only about half of 290 clinics in an urban area who participated in the VFC program in 2001 provided varicella vaccine to their patients.

OBJECTIVE(S):
To determine which factors influence a clinic’s decision to not order free varicella vaccine for children.

METHOD(S):
Public Health-Seattle & King County conducted a mail survey of VFC clinics. Standardized surveys were mailed to those clinics that participate in the VFC program but do not offer the varicella vaccine to their clients. Each mailed survey was followed by a reminder phone call with an opportunity for an oral interview.

RESULT(S):
The response rate for the survey was 90.7%. The two most frequently cited reasons for not providing the vaccine were 1) inadequate freezer storage unit (66%), and 2) lack of parent demand for the vaccine (38%). Further analysis showed that many providers responding with these two reasons also considered the vaccine to be a low priority and/or questioned the efficacy of the vaccine. Many providers indicate that an epidemiological argument might persuade them to begin using varicella vaccine.

CONCLUSIONS(S):
Many providers have considered varicella vaccine as a low priority compared to other vaccines for children. Easy availability of adequate freezers may motivate some providers to offer the vaccine, however provider views of the vaccine as a low priority or questions of efficacy need to be addressed. Providers may respond positively to an epidemiological argument suggesting that varicella vaccine is even more important when only a certain portion of the population is immunized.

LEARNING OBJECTIVES:
To explore factors that influence providers’ use of varicella vaccine.