Influenza A (H1N1) 2009 Monovalent Vaccine Delivery In the 2009-2010 Pandemic Season: The Experience of Primary Care Physicians

Background: In response to the emergence of a novel strain of influenza a rapid international response occurred including the expedited production of a vaccine. Primary care physicians' experiences with delivery of the vaccine have not been described.

Objectives: To determine, among primary care physicians: 1) willingness to administer Influenza A (H1N1) 2009 Monovalent Vaccine (pH1N1); 2) experiences with pH1N1 supply and delivery; and 3) perceived barriers to administration of pH1N1 during the 2009-2010 influenza season.

Methods: Two surveys administered to nationally representative samples of 416 pediatric (Peds), 424 family medicine (FM) and 432 general internal medicine (GIM) physicians before (pre-survey, 7/2009-10/2009) and after (post-survey, 3/2010-6/2010) the 2009-2010 influenza season.

Results: Response rates were 76% (pre-survey) and 69% (post-survey). On the pre-survey, almost all physicians reported being very/somewhat willing to provide pH1N1 in their offices (Peds 96%, FM and GIM 98%); post-survey, most reported administering pH1N1 when available (Peds 94%, FM and GIM 85%). Parental concern about safety of pH1N1 was the greatest perceived barrier in both the pre- (71%) and post- (72%) surveys. Physician concern about safety was a reported barrier for 62% of physicians in the pre- but only 12% in the post-survey. Most physicians reported having to cancel vaccination clinics due to delays or interruptions in the supply of pH1N1 (Peds, 68%, FM 51%, GIM 47%). The majority reported that demand was higher for pH1N1 than for seasonal vaccine in a typical year (adult patients 66%, children 79%).

Conclusions: Compared with physicians, patient and parent concern regarding safety of pH1N1 was a consistent issue during the 2009-2010 influenza season. Many providers cancelled influenza vaccination clinics due to interruptions or delays in vaccine supplies. A large majority of physicians ultimately reported delivering the novel vaccine in a pandemic setting. Such information will be useful in the event of another pandemic or other emerging infectious disease.