Subspecialists' Involvement In 2009-10 H1N1 Vaccination Effort

Background:  The 2009-10 H1N1 vaccination effort featured the first large-scale involvement of subspecialists that see adults and children at high risk for complications from influenza, who were included in the target groups for vaccination.  The involvement and experiences of these physicians during the H1N1 vaccination campaign may provide important lessons for future vaccination efforts targeting high-risk adults and children.

Objectives:  To understand the experiences of subspecialists during the 2009-10 H1N1 vaccination campaign.

Methods:  We conducted a mailed survey of a national random sample of 1,973 allergists/immunologists, 2,000 endocrinologists, and 2,000 pulmonologists in the summer of 2010.

Results:  Response rates were 71% allergists/immunologists, 58% endocrinologists, and 59% pulmonologists.  For all age groups, allergists/immunologists and pulmonologists were more likely than endocrinologists to “strongly recommend” H1N1 vaccine to their patients:  for children 18 years and younger (81% allergists/immunologists, 73% pulmonologists, 60% endocrinologists), for adults 25-64 years (45% vs 51% vs 35%, respectively), and for seniors 65 years and older (46% vs 53% vs 36%, respectively).  More allergists/immunologists (71%) and pulmonologists (60%) were H1N1 vaccine providers, compared to endocrinologists (52%).  More allergists/immunologists (64%) and pulmonologists (66%) said they would be “very likely” to provide vaccine in the event of a future influenza pandemic, compared to endocrinologists (47%).  All subspecialty groups endorsed greater willingness to provide seasonal influenza vaccine, with the majority reporting that they plan to offer seasonal influenza in 2010-11 (87% allergists/immunologists, 86% pulmonologists, 72% endocrinologists).

Conclusions:  Allergists/immunologists and pulmonologists appear to have had greater involvement in the 2009-10 vaccine campaign than endocrinologists.  However, across all subspecialty groups, many physicians did not strongly recommend H1N1 vaccine, particularly for high-risk adults.  Further efforts are needed to understand and address the reasons why subspecialists did not strongly endorse vaccination for their patients.