BACKGROUND:
The varicella vaccine shortage necessitated temporary changes in ACIP's recommendations for varicella immunization of children at 12-18 months to 18-24 months.

OBJECTIVE:
This study identifies factors associated with physician likelihood of recommending varicella vaccination after the 2002 shortage of varicella vaccine.

METHOD:
We surveyed 204 primary care physicians from Minnesota and Pennsylvania in 2003, assessing physicians' beliefs about varicella disease and vaccine and their likelihood of recommending varicella vaccine to two age groups of children after the shortage. Two multiple linear regression analyses examined the independent effects of variables on physician likelihood of recommendation for 12-18 month old and 4-6 year old children. Future analyses comparing physician behavior before and after the 2002 shortage will be presented.

RESULT:
After the shortage, most physicians were likely to recommend varicella vaccine for 12-18 month olds (81%) and 4-6 year olds (82%). Although 67% were aware of the 2002 varicella vaccine shortage, only 24% experienced shortages and 49% were aware of the 2002 temporary change in national recommendations. Multivariate analyses show that agreement with the national recommendation for 12-18 month olds was significantly associated with likelihood of recommending the vaccine for both age groups (P<0.05). In addition, physician perception that the parent desires vaccination for his/her child (P<0.05) and physician belief in the efficacy of the vaccine among 2 year olds (P<0.01) were positively associated with physician recommendation for 12-18 month old children.

CONCLUSION:
Following resolution of the 2002 shortage of varicella vaccine, less than half of physicians report that they were aware of the 2002 temporary change in national recommendations to delay administration of varicella vaccine. Strategies to communicate temporary changes in ACIP recommendations need to be improved.

LEARNING OBJECTIVES:
Participants will receive an update on how changes in vaccine supply, specifically the varicella vaccine shortage of 2002, influenced public policy and physician behavior.