Immunization Practices of Family Physicians

Background:
Family Physicians provide a significant proportion of vaccines to all age groups including adults, adolescents, children, and infants. The rate family physicians implement new vaccine recommendations affects the overall national rate of adherence to immunization recommendations. Family physician attitudes and practices on immunizations are important to understand.

Objectives:
The purpose of this study was to document the proportion of family physicians, by size of practice, who offer specific vaccines to patients at their practice locations and to examine family physician attitudes about referring patients to other, non physician locations, for immunizations.

Methods:
The annual AAFP immunization survey was sent in 2008 to 2000 randomly selected, active members of the AAFP who reported at least 80% time in direct patient care. The results of the 2008 survey were studied.

Results:
The response rate was 35.5%. Sixty-nine per cent of respondents say they have in place vaccine standing orders for adult patients and 50% have them in place for children. When patients are referred to other locations for immunizations it is usually (87% of the time) to a public health clinic. Family physicians either offer in the office, or refer elsewhere for, all recommended immunizations except for rotavirus; 20% report neither offering nor referring for this vaccine. Newer vaccines are offered on site less frequently than others and smaller practices, especially single physician practices, have more difficulty offering a full array of vaccines, usually for financial reasons.

Conclusions:
The financing of vaccines and immunization administration needs to be addressed to assist family physicians to offer a full spectrum of immunizations as part of the medical home.