Collaborative Approaches for Influenza Vaccine Delivery to Children--What Do Providers Think?

Background:  ACIP's expansion of recommendations for influenza delivery to include all children 6 mos.-18 years greatly increased the volume of children primary care physicians are recommended to vaccinate. Full implementation may require collaborative delivery models.

Objectives:To assess among Pediatricians (Peds) and Family Medicine (FM) physicians: 1) preferences regarding location of influenza vaccine receipt; 2) attitudes about collaborative methods of influenza vaccine delivery; and 3) barriers to collaborative delivery.

Methods:Nationally representative surveys of Peds and FM physicians conducted 7/2009-10/2009.

Results:Response rates were 79% for Peds and 70% for FM (N=628). The proportion of physicians that felt strongly that vaccination should occur in their office rather than elsewhere was highest when they were asked about children with chronic conditions (52%) and 6-24 mos. infants (48%); and lowest when asked about healthy 5-18 year olds (17%). A majority (78%) agreed that having multiple delivery sites increased vaccination rates among their patients. Physicians reported being very/somewhat willing to: participate with public health to set up community clinics where their patients could be vaccinated (76%); set up joint vaccination clinics with other practices (67%); and to suggest to sub-groups of their patients that they receive vaccine at public clinics or pharmacies (76%). Most frequently reported barriers to such collaborative approaches included the time/effort it would take (66%), concerns about transfer of records of vaccines given outside the practice (57%), difficulty estimating the amount of vaccine to order (56%), and reluctance of families to go to a site outside of the office (45%).

Conclusions: Despite some barriers, most Peds and FM physicians appear willing to collaborate with other practices and public health for influenza vaccine delivery, especially for school-aged children without chronic conditions. Such collaborations would require ensuring transfer of immunization records, communication with families, and provisions to protect providers from being left with extra influenza supply.