Willingness to Administer Influenza A (H1N1) 2009 Monovalent Vaccine: A National Physician Survey

Background: In response to the appearance of a novel strain of influenza there was a rapid international response including the expedited production of a vaccine.  The willingness of physicians to participate in the delivery of this vaccine was unknown.

Objectives: To determine among US pediatricians (Peds), family physicians (FM), and general internists (GIM): 1) willingness to administer Influenza A (H1N1) 2009 Monovalent Vaccine (2009 H1N1 vaccine) with limited information regarding safety and efficacy; and 2) barriers to use of the vaccine.

Methods: Surveys administered from 7/2009-10/2009 to 416 Peds, 424 FM and 432 GIM to nationally representative networks before 2009 H1N1 vaccine was distributed.

Results: Overall response rate was 76% (79% Peds, 70% FM, 78% GIM). The majority of physicians were either very willing (81%) or somewhat willing (15%) to provide 2009 H1N1 vaccine in their offices. Reported significant barriers to administering 2009 H1N1 vaccine in combination with seasonal vaccine included potential need for 3 or more visits to deliver all doses of influenza vaccines (34%), parental/patient concern that the vaccine may have unrecognized safety problems (26%), and lack of data regarding the effectiveness of the new vaccine (22%). A minority considered the following significant barriers: physician concern that 2009 H1N1 vaccine may have unrecognized safety problems (14%); inadequate storage space (7%); and the possibility that the vaccine would have to be administered under an Emergency Use Authorization (10%). Eighty-three percent were very/somewhat willing to forego administration fees for uninsured patients if the vaccine were provided at no cost.

Conclusions:  Although potential barriers were noted, our data suggest that private providers would be willing partners in the delivery of a new vaccine in the face of a pandemic, such as the 2009 H1N1 vaccine. Such information will be useful in the future in the event of another pandemic or other emerging infectious disease.