KEYWORD1:
influenza vaccine
barriers
vaccine providers

BACKGROUND:
Recent ACIP action to "encourage" influenza vaccination for 6- to 23-month-old children has wrought a substantial amount of uncertainty for providers of childhood vaccinations. Critical issues include provider agreement with the recommendation and its rationale, as well as logistical issues pertaining to vaccine supply and patient recall.

OBJECTIVE:
To conduct an early exploration of provider issues related to implementation of the pediatric influenza vaccine "encouragement" for 2003-04.

METHOD:
Two mailed surveys were conducted. The first included 440 large VFC providers from six immunization programs; the second included a national random sample of primary care pediatricians and family physicians. Specific survey items included: provider estimates of 2003-04 influenza vaccination rates, estimates of order size, barriers to implementation, and practice demographics. Surveys were fielded in October/November 2002.

RESULT:
Preliminary results indicate that less than half of providers would vaccinate all 6- to 23-month-olds based on the current encouragement. Provider estimates of influenza vaccination rates varied widely, from 0% to 100%. A considerable proportion of providers indicated that vaccination rates for VFC-eligible children would be lower if private insurance did not cover influenza vaccine (i.e., providers did not want to have different practices based on children's insurance status). Estimated order sizes frequently did not correspond to practice size and expected vaccination rate. Providers expected that the most common barriers to implementation would be lack of parent acceptance, difficulty recalling children for influenza vaccination, and concerns about vaccine supply.

CONCLUSION:
Considerable effort will be needed to promote adoption of the influenza vaccine encouragement for 6- to 23-month-olds. Areas to target include better explanation of the rationale for the encouragement for both providers and parents, assistance with ordering, and assistance with patient recall.
LEARNINGOBJECTIVES:
Participants will gain an understanding of provider attitudes and expectations regarding the implementation of pediatric influenza vaccination for the 2003-04 season.