Provider adoption of pneumococcal conjugate vaccine and the impact of vaccine shortages

被引:8
作者
Daley, MF
Crane, LA
Beaty, BL
Barrow, J
Pearson, K
Stevenson, JM
Berman, S
Kempe, A
机构
[1] Univ Colorado, Hlth Sci Ctr, Dept Pediat, Denver, CO 80262 USA
[2] Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80262 USA
[3] Childrens Outcomes Res Program, Denver, CO USA
[4] Childrens Hosp, Denver, CO 80218 USA
[5] Ctr Dis Control & Prevent, Natl Immunizat Program, Atlanta, GA USA
关键词
immunization; pneumococcal conjugate vaccine; provider attitudes; vaccine shortages;
D O I
10.1367/A04-142R.1
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objectives.-To 1) determine the factors associated with provider acceptance of pneumococcal conjugate vaccine and 2) describe how providers prioritize pneumococcal conjugate vaccine during shortages. Design/Methods.-During April-November 2002, we conducted a mailed survey of rural and urban Colorado practitioners who provided routine pediatric immunizations. Three groups were surveyed: 1) all immunization providers (n = 51) in 2 geographically large rural areas, identified through a regional immunization registry; 2) all providers (n 61) from private pediatric practices in metropolitan Denver that were actively participating in the same registry; and 3) all family physicians (n = 244) from the same urban areas as the pediatric practices. Results.-Response rate was 60 %. Provider adoption of pneumococcal conjugate vaccine was strong: 66 % of urban family physicians, 84 % of rural providers, and 98% of urban pediatric providers always recommended pneumococcal conjugate vaccine to healthy children : 23 months old when vaccine supplies were adequate. In multivariate analysis, vaccine nonadopters were significantly more likely than adopters to report financial barriers to vaccination (odds ratio [OR] 3.17, 95 % confidence interval [CI] 1.58, 6.35) and concerns about vaccine safety (OR 3.37, 95 % Cl 1.37, 8.26). Eighty-nine percent of respondents had encountered pneumococcal conjugate vaccine shortages. During shortages, children < 5 years old with a chronic medical condition were considered the highest priority for vaccination. Conclusions.-While provider acceptance of pneumococcal conjugate vaccine appears high, concerns about vaccine safety, cost, and availability exist, and these concerns will need to be addressed to maximize prevention of invasive pneumococcal disease in children.
引用
收藏
页码:157 / 164
页数:8
相关论文
共 64 条
[51]   Pneumococcal conjugate vaccines: proceedings from an Interactive Symposium at the 41st Interscience Conference on Antimicrobial Agents and Chemotherapy [J].
Pelton, SI ;
Dagan, R ;
Gaines, BM ;
Klugman, KP ;
Laufer, D ;
O'Brien, K ;
Schmitt, HJ .
VACCINE, 2003, 21 (15) :1562-1571
[52]   The impact of immunization record aggregation on up-to-date rates-implications for immunization registries in rural areas [J].
Renfrew, BL ;
Kempe, A ;
Lowery, NE ;
Chandramouli, V ;
Steiner, JF ;
Berman, S .
JOURNAL OF RURAL HEALTH, 2001, 17 (02) :122-126
[53]   Rotavirus vaccine and intussusception: How much risk will parents in the united states accept to obtain vaccine benefits? [J].
Sansom, SL ;
Barker, L ;
Corso, PS ;
Brown, C ;
Deuson, R .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 2001, 154 (11) :1077-1085
[54]  
Schafer J.L, 1997, ANAL INCOMPLETE MULT
[55]   Physician perspectives regarding pneumococcal conjugate vaccine [J].
Schaffer, SJ ;
Szilagyi, PG ;
Shone, LP ;
Ambrose, SJ ;
Dunn, MK ;
Barth, RD ;
Edwards, K ;
Weinberg, GA ;
Balter, S ;
Schwartz, B .
PEDIATRICS, 2002, 110 (06) :e68
[56]  
Schaffer SJ, 1999, ARCH PEDIAT ADOL MED, V153, P357
[57]   Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine [J].
Whitney, CG ;
Farley, MM ;
Hadler, J ;
Harrison, LH ;
Bennett, NM ;
Lynfield, R ;
Reingold, A ;
Cieslak, PR ;
Pilishvili, T ;
Jackson, D ;
Facklam, RR ;
Jorgensen, JH ;
Schuchat, A .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 348 (18) :1737-1746
[58]   Progress in coverage with hepatitis B vaccine among US children, 1994-1997 [J].
Yusuf, HR ;
Coronado, VG ;
Averhoff, FA ;
Maes, EF ;
Rodewald, LE ;
Battaglia, MP ;
Mahoney, FJ .
AMERICAN JOURNAL OF PUBLIC HEALTH, 1999, 89 (11) :1684-1689
[59]   What's the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes [J].
Zhang, J ;
Yu, KF .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1998, 280 (19) :1690-1691
[60]  
Zimmerman RK, 1998, ARCH PEDIAT ADOL MED, V152, P12