Major Finding: Seventy-seven percent of pediatricians and family physicians reported being very or somewhat willing to participate with public health organizations to set up community clinics where their patients could be vaccinated, and 76% reported being very or somewhat willing to refer certain patients to public clinics or pharmacies.
Data Source: A national survey of 628 pediatricians and family physicians conducted July through October 2009.
Disclosures: None was reported.
ATLANTA — Although they would rather vaccinate children in their own offices, pediatricians and family physicians appear willing to collaborate with other practices and public health clinics to facilitate influenza vaccine delivery, based on a national survey.
They have significant concerns, however, including potential records-transfer problems and being left with surplus vaccine, reported Dr. Allison Kempe, director of the children's outcomes research program at the University of Colorado at Denver.
In the survey of pediatricians and family physicians conducted July through October 2009, a majority (78%) of the 628 physicians responded strongly or somewhat agreed that having multiple delivery sites increased vaccination rates among their patients.
The physicians reported being very or somewhat willing to:
▸ Participate with public health organizations to set up community clinics where their patients could be vaccinated: 77%.
▸ Refer certain patients to public clinics or pharmacies: 76%.
▸ Refer patients to other practices for vaccines: 50%.
▸ Vaccinate patients from other practices: 49%.
In addition, almost all indicated a willingness to sell vaccine to public health clinics (92%) or buy extra vaccine from them (90%).
This reflects the frustrations physicians have with vaccine supply and delivery problems, she said.
Among the frequently cited barriers are:
▸ Concerns about transfer of records of vaccines (“record scatter”): 57% (25% identified it as significant).
▸ Difficulty estimating the amount of vaccine to order: 56% (23% called it significant).
▸ Time and effort required: 31% (23% called it significant).
▸ Reluctance of families to use another site: 45% (11% called it significant).
In general, the responses of the pediatricians and family physicians were similar, Dr. Kempe said at the conference sponsored by the Centers for Disease Control and Prevention.
But she pointed out two important differences: Pediatricians were more likely to believe strongly that infants should be vaccinated in their medical home, and family physicians indicated a greater willingness to collaborate.
She noted the findings correspond with her observation that the willingness to collaborate on vaccine delivery has increased since the 2009 H1N1 flu outbreak.
Dr. Kempe cited a growing need for collaboration.
The CDC Advisory Committee on Immunization Practices's recommendations have been rapidly expanding over the last 5 years, which has been “somewhat difficult for primary care physicians to deal with,” she said, and noted, “If all the influenza vaccinations were given in the medical home, it is estimated that 42–49 million additional visits might be needed in a given year.”
Moreover, most primary care physicians are not actively re-calling all children, and if they did, they might be unable to handle the increased volume, she said.
“Clearly, collaboration between the different vaccine sectors may be very advantageous to this process,” Dr. Kempe said.