Physician Support for Vaccination of Adolescents In Schools: A Survey of Colorado Pediatricians and Family Physicians

Background: School-located vaccinations have been proposed as a means to improve vaccination rates among adolescents. However, knowledge is limited regarding physician support for delivering vaccines to adolescents at school and billing by the school vaccinator for services provided. In order to bill publicly insured patients in Colorado, a physicians’ Medicaid number might be required to bill Medicaid-insured patients.

Objectives: To assess physician vaccination beliefs, support for delivering vaccines to adolescents at school and support for billing for services provided.

Methods: During July–September 2010, a 20-item survey was mailed to a random sample of 1,337 practicing Colorado pediatricians and family physicians. The survey assessed support for school-located vaccinations and whether physicians are willing to provide their Medicaid number to the vaccinator for billing purposes.

Results: 394 physicians in the sample were determined to be ineligible and excluded (not practicing primary care). Of 943 eligible physicians, 584 responded (62%). Of question respondents, a majority were supportive of school-located vaccination: 80% (459/573) somewhat/very supportive for publicly insured patients and 75% (433/579) for privately insured patients. Among respondents, 84% (491/582) agreed/somewhat agreed that school-located vaccination is easier and more convenient for their patients and parents. Although physicians were supportive of school-located vaccination, only 42% (228/544) were willing to provide their Medicaid number for billing for their publicly insured patients. Respondents’ most common concerns for school-located vaccination included “difficulty estimating the amount of vaccine to order” (77% (441/570) agreed/somewhat agreed), “patients less likely to come in for well-child visits” (77% (447/579) agreed/somewhat agreed), and “difficulty maintaining immunization records” (72% (410/573) agreed/somewhat agreed).

Conclusions: Colorado physicians support adolescent school-located vaccinations but expressed concerns of negative impacts to their practice. Reasons why Colorado physicians supported school-located vaccination but would not provide their Medicaid number for billing of vaccines administered at school merits further examination.