Tuesday, March 18, 2008

Pediatricians' Perspectives on the Use of Settings Outside the Medical Home to Vaccinate Adolescents

Stanley J. Schaffer1, Christina Albertin1, Cynthia M. Rand1, Sharon Humiston2, Laura P. Shone1, Aaron K. Blumkin1, and Peter G. Szilagyi1. (1) Department of Pediatrics, University of Rochester, 601 Elmwood Ave, Box 777, Rochester, NY, USA, (2) Department of Emergency Medicine, University of Rochester, Box 655, 601 Elmwood, Rochester, NY, USA

Learning Objectives for this Presentation:
By the end of the presentation participants will be able to understand pediatricians' perspectives about utilizing settings outside the medical home to vaccinate adolescents.

A number of new vaccinations have been recommended for adolescents over the past 2 years. Influenza vaccine may also soon be universally recommended for adolescents.

To assess pediatricians' perspectives about settings outside the traditional medical home where adolescents potentially could be vaccinated.

A 47-item survey was sent in 2006-07 to 806 U.S. pediatricians. They were asked about the suitability of various settings (pharmacies, schools, family planning clinics, teen clinics, school-based health centers, health departments and hospital emergency departments) for the provision of specific vaccinations for their adolescent patients, and what factors would make such settings suitable or unsuitable. Completed surveys were received from 374 (47% of) surveyed pediatricians. Descriptive statistics and chi-square analyses were performed.

Over 70% of responding pediatricians thought it would be suitable to vaccinate adolescents with influenza vaccine in all of the settings. Half or more of respondents thought it would be suitable to provide meningococcal conjugate, Tdap and HPV vaccines at health departments, teen clinics, school-based health centers, family planning clinics and in schools. While 76% indicated that it would be suitable to provide Tdap in emergency departments, 46% and 37% respectively thought it would be suitable to provide meningococcal conjugate vaccine and HPV vaccine there. 66% of respondents thought it would be suitable to give the second or third dose of HPV vaccine in an outside setting. The most important consideration for pediatricians in determining the suitability of such settings was receiving notification that their patients had received vaccinations there, while increasing the likelihood that their patients would receive vaccinations was their next most important consideration.

Pediatricians generally support their adolescent patients having the opportunity to be vaccinated in outside settings.