KEYWORDS:
pneumococcal conjugate vaccine, family physician, pediatrician

BACKGROUND:
Pneumococcal conjugate vaccine (PCV7) was recommended in spring 2000 for universal administration to children <2 yrs old and for children 2-5 yrs at increased risk for pneumococcal disease.

OBJECTIVE(S):
To identify physician factors associated with recommending vs not recommending PCV7.

METHOD(S):
Cross-sectional mail survey in spring 2001 of a random sample of 1600 pediatricians (PD) and family physicians (FP) in 24 states. Survey items included perceived effectiveness of PCV7, prior clinical exposure to severe pneumococcal disease, and comfort with multiple injections. Proportions of recommenders (REC) and non-recommenders (N-REC) were compared using likelihood ratio chi-square tests.

RESULT(S):
Response rate was 60%. Overall, 87% of physicians recommend PCV7: 99% PD vs 68% FP (p<.001). Given high uptake among PD, REC and N-REC were compared for FP only. REC FPs are more likely than N-REC FPs to believe that PCV7 will effectively prevent invasive pneumococcal meningitis (47% vs 25%, p<.001), sepsis (43% vs 23%, p<.001) and pneumonia (33% vs 25%, p<.05), and more likely to expect PCV7 to prevent >25% of otitis media cases (33% vs 22%, p<.05). REC FPs also are more likely to consider giving 4 or more vaccine injections at one visit (86% vs 35%, p<.001) and less likely to express concerns about pain (49% vs 78%, p<.001) or adverse effects (26% vs 43%, p<.01) associated with multiple injections.

CONCLUSIONS(S):
Almost all pediatricians currently recommend PCV7 in their practices. Efforts to improve uptake among FP non-recommenders may need to focus on perceptions of PCV7's effectiveness regarding invasive pneumococcal disease and willingness to administer 4 injections at one visit.

LEARNING OBJECTIVES:
To identify perceptions or issues hindering provider acceptance of PCV7.