Physician Adherence to the ACIP Recommendations Regarding Influenza Vaccine in Children: A National Physician Survey

Background: In 2008, the Advisory Committee on Immunization Practices (ACIP) expanded recommendations for yearly influenza vaccination to include all children 6 months to 18 years if feasible. It is unknown to what degree physicians have been adherent to this recommendation.

Objectives: To assess current practices regarding the expanded ACIP recommendations for influenza vaccination in children among U.S. pediatricians (Peds) and Family Medicine physicians (FM).

Methods: We administered a survey from July 2009-October 2009 to 416 pediatricians and 424 Family Medicine physicians from a nationally representative network.

Results: The overall response rate was 75% (79% Peds, 71% FM). FM were less likely than Peds to report adherence to the ACIP recommendations (42% vs 70%, RR 0.54, 95% CI 0.45-0.64). Rural practices were less likely than urban practices to adhere (RR 0.67, 95% CI 0.51-0.86). Practice factors associated with adherence included: participation in the Vaccines for Children Program (RR 1.49, 95% CI 1.20-1.85), dedicating extra staff for vaccine-only visits (RR 1.24, 95%CI 1.05-1.45), offering after-hours dedicated influenza vaccination clinics (RR 1.45, 95% CI 1.23-1.70), providing written, telephone, or email reminders to all children 6 months to 18 years (RR 1.44, 95% CI 1.23-1.68), and having practice-based websites or newsletters promoting influenza vaccination in children (RR 1.19, 95% CI 1.02-1.39).

Conclusions:  In the first year of the expanded ACIP recommendations to immunize all children 6 months to 18 years of age against influenza, more than two-thirds of Peds and just under half of FM report adherence. Adhering practices were more likely to be putting substantial effort into promoting vaccination opportunities at the practice.