Abstract
Objective
Achieving universal influenza vaccination among children may necessitate collaborative
delivery involving both practices and community vaccinators. We assessed among pediatricians
nationally their preferences regarding location of influenza vaccination for patient
subgroups and their attitudes about collaborative delivery methods.
Methods
The design/setting was a national survey conducted from July 2009 to October 2009.
Participants included a representative sample of pediatricians from the American Academy
of Pediatrics.
Results
The response rate was 79% (330 of 416). Physicians felt strongly that vaccination
should occur in their practice for children with chronic conditions (52%) and healthy
6–24-month-old infants (48%), but few felt strongly about healthy 5–18-year-olds (17%).
Most (78%) thought having multiple delivery sites increased vaccination rates, and
86% thought that influenza vaccine should be available at school. Physicians reported
being very/somewhat willing to hold joint community clinics with public health entities
(76%) and to suggest to patient subgroups that they receive vaccine at community sites,
including public clinics or pharmacies (76%). The most frequently reported barriers
to collaborative delivery with community sites or school-located delivery included
concerns about the following: estimating the amount of vaccine to order if children
are vaccinated elsewhere (community 56%; school 80%); transfer of vaccine records
(community 57%; school 78%); and reluctance of families to go outside of the office
(community 45%; school 74%).
Conclusions
Most physicians are in favor of school-located or collaborative influenza vaccine
delivery with community vaccinators, especially for healthy school-aged children.
Collaborative approaches will require planning to ensure transfer of records, effective
targeting of subgroups, and provisions to protect providers from being left with extra
influenza supply.
Keywords
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References
- Influenzavirus infections in Seattle families, 1975–1979. I. Study design, methods and the occurrence of infections by time and age.Am J Epidemiol. 1982; 116: 212-227
- Interpandemic influenza in the Houston area, 1974–76.N Engl J Med. 1978; 298: 587-592
- Burden of influenza in children in the community.J Infect Dis. 2004; 190: 1369-1373
- Acute respiratory illness in the community. Frequency of illness and the agents involved.Epidemiol Infect. 1993; 110: 145-160
- The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children.N Engl J Med. 2000; 342: 225-231
- Illness among schoolchildren during influenza season: effect on school absenteeism, parental absenteeism from work, and secondary illness in families.Arch Pediatr Adolesc Med. 2002; 156: 986-991
- Influenza immunization of schoolchildren: can we interrupt community epidemics?.Pediatrics. 1999; 103: 1280-1282
- Population-wide benefits of routine vaccination of children against influenza.Vaccine. 2005; 23: 1284-1293
- Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2008.MMWR Recomm Rep. 2008; 57: 1-60
- Additional visit burden for universal influenza vaccination of US school-aged children and adolescents.Arch Pediatr Adolesc Med. 2008; 162: 1048-1055
- Impact of a severe influenza vaccine shortage on primary care practice.Am J Prev Med. 2007; 33: 486-491
- Late season influenza vaccination: a national survey of physician practice and barriers.Am J Prev Med. 2010; 39: 69-73
- Impact of the 2004–2005 influenza vaccine shortage on pediatric practice: a national survey.Pediatrics. 2009; 123: e186-e192
- A qualitative study of physicians’ experiences ordering and receiving influenza vaccine during the 2005–2006 influenza season.Prev Med. 2008; 47: 225-228
National Influenza Vaccine Summit, April 2007. Meeting minutes. Available at: http://www.preventinfluenza.org/summits/2007/meeting_minutes07.pdf. Accessed September 22, 2010.
- Pharmacist involvement with immunizations: a decade of professional advancement.J Am Pharm Assoc. 2006; 46: 168-179
- Where adults reported receiving influenza vaccination in the United States.Am J Infect Control. 2005; 33: 563-570
- Expanding the delivery of clinical preventive services through community collaboration: the SPARC model.Prev Chronic Dis. 2008; 5: A20
- Launching a community-wide flu vaccination plan.Fam Pract Manag. 2008; 15: 19-22
- “McFlu.” The Monroe County, New York, Medicare vaccine demonstration.Am J Prev Med. 1999; 16: 118-127
- A coordinated, communitywide program in Monroe County, New York, to increase influenza immunization rates in the elderly.Arch Intern Med. 1994; 154: 1741-1745
- Sentinel physician networks as a technique for rapid immunization policy surveys.Eval Health Prof. 2008; 31: 43-64
- The Practice of Social Research.4th ed. Wadsworth, Belmont, Calif1986
- Comparison of e-mail, fax, and postal surveys of pediatricians.Pediatrics. 2003; 111: e299-e303
- Lessons learned: role of influenza vaccine production, distribution, supply, and demand—what it means for the provider.Am J Med. 2008; 121: S22-S27
- Cost of universal influenza vaccination of children in pediatric practices.Pediatrics. 2009; 124: S499-S506
- Getting under the hood: exploring issues that affect provider-based recall using an immunization information system.Acad Pediatr. 2011; 11: 44-49
- Adoption of reminder and recall messages for immunizations by pediatricians and public health clinics.Pediatrics. 2003; 112: 1076-1082
- The daunting practicalities of in-office pediatric influenza vaccination, 2009–2010.Pediatr Ann. 2009; 38: 655-660
- Influenza vaccination coverage among children with asthma—United States, 2004–05 influenza season.MMWR Morb Mortal Wkly Rep. 2007; 56: 193-196
- At what sites are parents willing to have their 11 through 14-year-old adolescents immunized?.Vaccine. 2010; 28: 2674-2678
Kelminson K, Saville A, Seewald L, et al. Parental views of school-based vaccine delivery. Paper presented at: 44th National Immunization Conference; April 19–22, 2010; Atlanta, Ga. Abstract available at: http://cdc.confex.com/cdc/nic2010/webprogram/Paper22612.html. Accessed August 4, 2011.
- Adolescent immunization practices: a national survey of US physicians.Arch Pediatr Adolesc Med. 2001; 155: 566-571
- Parental attitudes about influenza immunization and school-based immunization for school-aged children.Pediatr Infect Dis J. 2010; 29: 751-755
- Mass distribution of free, intranasally administered influenza vaccine in a public school system.Pediatrics. 2007; 120: e172-e178
- Statewide school-located influenza vaccination program for children 5–13 years of age, Hawaii, USA.Emerg Infect Dis. 2010; 16: 244-250
- School-based influenza immunization.Vaccine. 2008; 26: 4312-4313
- Effectiveness of school-based influenza vaccination.N Engl J Med. 2006; 355: 2523-2532
- School-based influenza vaccine delivery, vaccination rates, and healthcare use in the context of a universal influenza immunization program: an ecological study.Vaccine. 2010; 28: 2722-2729
- Impact of a school-based influenza immunization program on disease burden: comparison of two Tennessee counties.Vaccine. 2009; 27: 2695-2700
- Effect of influenza vaccination of children on infection rates in Hutterite communities: a randomized trial.JAMA. 2010; 303: 943-950
- Universal influenza vaccination and live attenuated influenza vaccination of children.Pediatr Infect Dis J. 2008; 27: S104-S109
- Community interventions and the epidemic prevention potential.Vaccine. 2002; 20: 3254-3262
- Strategy for distribution of influenza vaccine to high-risk groups and children.Am J Epidemiol. 2005; 161: 303-306
- Strategies for pandemic and seasonal influenza vaccination of schoolchildren in the United States.Am J Epidemiol. 2009; 170: 679-686
- Optimizing influenza vaccine distribution.Science. 2009; 325: 1705-1708
- Universal vaccination of children against influenza: are there indirect benefits to the community? A systematic review of the evidence.Vaccine. 2006; 24: 1047-1062
Centers for Disease Control and Prevention. Results from the November 2010 Rapid Flu Survey—United States, 2010–11 influenza season. 2011. Available at: http://www.cdc.gov/flu/pdf/vaccination/rapidflusurvey.pdf. Accessed January 10, 2011.
- Herd immunity in adults against influenza-related illnesses with use of the trivalent-live attenuated influenza vaccine (CAIV-T) in children.Vaccine. 2005; 23: 1540-1548
- Modification of an outbreak of influenza in Tecumseh, Michigan by vaccination of schoolchildren.J Infect Dis. 1970; 122: 16-25
- Benefits and costs of immunizing children against influenza at school: an economic analysis based on a large-cluster controlled clinical trial.Health Aff (Millwood). 2008; 27: w96-w104
- Universal influenza vaccination in the United States: are we ready? Report of a meeting.J Infect Dis. 2006; 194: S147-S154
National Influenza Vaccine Summit, June 2006. Meeting minutes. Available at: http://www.ama-ssn.org/resources/doc/infectious-disease/2006_summit_minutes.pdf. Accessed August 10, 2011.
- Influenza vaccine supply, 2005–2006: did we come up short? BMC.Health Serv Res. 2007; 7: 66
- Updated recommendations from the Advisory Committee on Immunization Practices in response to delays in supply of influenza vaccine for the 2000–01 season.MMWR Morb Mortal Wkly Rep. 2000; 49: 888-892
- Delayed influenza vaccine availability for 2001–02 season and supplemental recommendations of the Advisory Committee on Immunization Practices.MMWR Morb Mortal Wkly Rep. 2001; 50: 582-585
- Interim influenza vaccination recommendations, 2004–2005 influenza season.MMWR Morb Mortal Wkly Rep. 2004; 53: 923-924
National Influenza Vaccine Summit, June 2009. Meeting minutes. Available at: http://www.preventinfluenza.org/NIVS_2009/summit_minutes.pdf. Accessed September 1, 2010.
- Regional influenza A (H1N1) 2009 monovalent vaccination campaign—Skokie, Illinois, October 16–December 31, 2009.MMWR Morb Mortal Wkly Rep. 2010; 59: 909-913
Article info
Publication history
Published online: September 07, 2011
Accepted:
July 28,
2011
Received:
April 26,
2011
Footnotes
The authors have no conflicts of interest to disclose.
Identification
Copyright
© 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
