KEYWORDS:
immunization, combination vaccines, satisfaction

BACKGROUND:
Combination vaccine use reduces the number of injections administered at infant vaccination visits. Little is known about physician and vaccinator satisfaction with these visits.

OBJECTIVE:
Measure staff satisfaction with infant vaccination visits, and the effects of number of injections on satisfaction.

METHOD:
Physicians and vaccinators from 35 private pediatric centers self-administered a questionnaire. A 3-inch visual analog scale was used to score agreement with questionnaire statements from 0 to 100, with higher scores indicating more agreement. Items were worded in a negative perspective to limit acquiescence bias.

RESULT:
All 84 pediatricians not personally administering vaccines and all 147 vaccinators (including 10 physicians who administer vaccines) completed the survey. For both groups, an increasing number of injections predicted satisfaction with each component of the vaccination process, including "Difficult to Obtain Parental Consent," "Too Much Time to Prepare and Administer," "I Get Upset during Vaccine Administration," and "Too Much Time to Update Records," (each p<.0001). The relationship between satisfaction and injections was nonlinear, with satisfaction decreasing markedly for 4-and 5-injection visits. 95%-97% of non-vaccinating physicians and vaccinators agreed that all infants should receive all vaccinations due, assuming no contraindication or supply shortage, at visits when 1-3 injections are due. Yet agreement decreased to 61% and 69% for non-vaccinating pediatricians and vaccinators, respectively, when 5 injections are due (p<.0001).

CONCLUSION:
Non-vaccinating pediatricians and vaccinators are satisfied with vaccination visits of <4 injections, and dissatisfied with those involving ³4 injections.

LEARNING OBJECTIVES:
To understand clinician satisfaction with infant vaccination visits, and the effect of the number of injections on satisfaction