Tuesday, March 18, 2008 - 4:25 PM

Adherence to New Pediatric Recommendations for Influenza Vaccination Among Pediatric and Family Medicine Physicians

Allison Kempe1, Lon McQuillan2, Matthew F. Daley1, Pascale M. Wortley3, Lori A. Crane4, Brenda L. Beaty5, Jennifer Barrow5, Christine Babbel5, and Miriam Dickinson6. (1) Department of Pediatrics, University Colorado Denver, Children's Outcomes Research Program, The Children's Hospital, 1056 E. 19th Avenue, Denver, CO, USA, (2) Children's Outcomes Research Program, The Children's Hospital, Department of Pediatrics, University of Colorado Denver, (3) Health Services Research & Evaluation Branch, National Immunization Program, CDC, (4) Preventive Medicine & Biometrics, University of Colorado Denver, (5) Colorado Health Outcomes Program, University of Colorado Denver, (6) Dept. of Family Medicine, University of Colorado Denver

Learning Objectives for this Presentation:
By the end of the presentation participants will be able to describe adherence to new pediatric influenza recommendations

In 2004 influenza vaccine recommendations were expanded to include 6-23 month olds and, in 2006, they were further expanded to include 24-59 month olds

To assess among Pediatric (Peds) and Family Medicine (FM) physicians: 1) current vaccination practices for children 6-23 and 24-59 months; 2) barriers to implementation of recommendations for 24-59 month olds; and 3) factors associated with adherence to recommendations

A sample of Peds and FM representative of national specialty organizations were surveyed by e-mail or mail between 3/07-6/07

Response rate was 75% (N=639). For 6-23 month olds, 95% of Peds routinely and 5% selectively vaccinated; 72% of FM vaccinated routinely, 22% selectively and 6% did not vaccinate. For 24-59 month olds, 80% of Peds routinely and 20% selectively vaccinated; 42% of FM vaccinated routinely, 49% selectively and 8% did not vaccinate. Factors reported as barriers included concerns about having enough vaccine supply (Peds 48%, FM 47% p=NS), parental doubts about the necessity of vaccination in this age group (Peds 35%, FM 45% p<0.01), insurance coverage (Peds 27%, FM 34% p=NS), ability of the practice to handle increased time and resources (Peds 24%, FM 25% p=NS), the need to educate parents regarding new recommendations (Peds 19%, FM 39% p<0.0001) and not seeing 24-59 month olds frequently enough (Peds 13%, FM 32%, p<0.0001)

Three years out from ACIP's recommendations for 6-23 month olds, reported adherence is almost universal among Peds, but not among FM. A year after expanded recommendations for 24-59 month olds, adherence is high among Peds, but less than half of FM report adhering. Providers in both specialties report concerns about vaccine supplies as the major barrier to adherence with expanded recommendations