Tuesday, March 18, 2008

Characteristics and Attitudes of Private Pediatric Practices in Georgia: Association with Influenza Immunization Efforts

Karen Pazol1, Julie, A. Gazmararian2, Mila M. Prill3, Emily M. O'Malley2, Deborah D. Jelks4, Margaret S. Coleman5, Alan R. Hinman6, and Walter A. Orenstein1. (1) School of Medicine, Division of Infectious Diseases, Emory University, 1462 Clifton Rd NE, Suite 446, Atlanta, GA, USA, (2) School of Public Health, Department of Health Policy and Management, Emory University, Atlanta, GA, USA, (3) Logistics Health Inc, Atlanta, GA, USA, (4) Georgia Immunization Program, Georgia Department of Human Resources, Division of Public Health, Atlanta, GA, USA, (5) Centers for Disease Control and Prevention, Atlanta, GA, USA, (6) The Task Force for Child Survival and Development, Decatur, GA, USA

Learning Objectives for this Presentation:
By the end of this presentation participants will be able to list: 1) the policies pediatric practices implement that are associated with greater intent to vaccinate (ItV) children against influenza; 2) measures pediatric practices consider important for implementing universal vaccination policies.

The Advisory Committee on Immunization Practices (ACIP) is considering recommending universal pediatric influenza vaccination. Healthcare provider endorsement will be critical for implementing this policy.

To assess pediatric practices associated with greater ItV children against influenza.

Knowledge of current recommendations, immunization practices, and attitudes and beliefs about universal childhood vaccination were assessed through a survey of 35 private pediatric practices randomly selected from Georgia's Vaccines for Children (VFC) program participants. The ratio of influenza vaccine VFC doses ordered, relative to measles, mumps, rubella (MMR) doses ordered, was used as a surrogate measure of intent to vaccinate (ItV). Data were analyzed in SAS (version 9.1).

Most healthcare providers were well informed about current influenza vaccine recommendations. Those practices which added extra hours during the vaccination season (p=0.012), and those with a policy of allowing ≥ 6 injections to be delivered at one appointment, showed greater ItV (p=0.008). All respondents indicated that having a formal AAP/ACIP recommendation and assurance they could receive compensation for unused vaccine, were factors that would encourage clinics to adopt a universal vaccination policy: for both measures, 86% of respondents indicated these considerations would be extremely or very important, and the remaining 14% of respondents indicated they would be important.

Pediatric clinics with the greatest ItV expanded their capacity to deliver vaccine by adding additional hours for vaccination and had policies in place to take advantage of providing all indicated vaccines simultaneously. Findings further suggest a formal AAP/ACIP recommendation and assurance of compensation for unused vaccine will be instrumental for encouraging pediatricians to vaccinate their entire patient base.