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

Background:
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

Objectives:
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

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

Results:
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)

Conclusions:
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