Published online January 2, 2007
PEDIATRICS Vol. 119 No. 1 January 2007, pp. 1-10 (doi:10.1542/10.1542/peds.2006-1874)
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ARTICLE

Will Pediatricians Adopt the New Rotavirus Vaccine?

Allison Kempe, MD, MPHa,b,c, Matthew F. Daley, MDa,b,c, Umesh D. Parashar, MBBS, MPHd, Lori A. Crane, PhD, MPHc,e, Brenda L. Beaty, MSPHb, Shannon Stokley, MPHf, Jennifer Barrow, MSPHc, Christine Babbel, MSPHc, L. Miriam Dickinson, PhDg, Marc-Alain Widdowson, VetMB, MScd, James P. Alexander, MD, MA, Medd and Stephen Berman, MDa,c

a Departments of Pediatrics
e Preventive Medicine and Biometrics
g Family Medicine
b Colorado Health Outcomes Program, University of Colorado at Denver and Health Sciences Center, Denver, Colorado
c Children’s Outcomes Research Program, Children’s Hospital, Denver, Colorado
d Epidemiology Branch, Division of Viral Diseases
f Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

OBJECTIVES. Our objective was to determine the following among US pediatricians: (1) perceptions regarding burden of rotavirus disease and need for a vaccine; (2) intentions for recommending a newly licensed rotavirus vaccine; (3) perceived barriers to implementation; and (4) factors associated with plans for vaccine adoption.

PATIENTS AND METHODS. A network of 431 pediatricians was recruited from a random sample of American Academy of Pediatrics’ members. The network was designed to be representative of the American Academy of Pediatrics with respect to region of the country, practice type, and practice setting. During January and February 2006, physicians were surveyed by Internet or mail. The survey contained a paragraph summarizing results of the new rotavirus vaccine trial. Respondents were asked about intentions to use the vaccine and anticipated barriers.

RESULTS. The survey response rate was 71%. Of the respondents, 52% strongly agreed and 37% somewhat agreed with the need for a rotavirus vaccine. If recommended for routine use, 50% would strongly recommend and 34% would recommend but not strongly; 52% would begin to use within 6 months and 27% from 6 months to 1 year. The top 3 "definite" barriers to implementation included concerns about uniform coverage of vaccine by insurers, lack of adequate reimbursement, and parental reluctance because of withdrawal of previous rotavirus vaccine. In multivariate analysis, factors associated with very likely adoption of the vaccine included perception of a high burden of rotavirus disease and a high level of confidence in prelicensure studies of vaccine safety. The presence of physician concerns about safety of the new vaccine and the perception of parental concerns about vaccine safety in general were negatively associated with adoption.

CONCLUSIONS. The majority of pediatricians reported willingness to implement the new rotavirus vaccine, most within 6 months. Major barriers to optimal implementation included provider concerns about reimbursement issues and parental acceptance of the vaccine.

Key Words: immunization • rotavirus vaccine • physician attitudes

Abbreviations: FDA—Food and Drug Administration • ACIP—Advisory Committee on Immunization Practices • CDC—Centers for Disease Control and Prevention • AAP—American Academy of Pediatrics • AMA—American Medical Association • VFC—Vaccines for Children • PCV7—heptavalent pneumococcal conjugate vaccine

Accepted Sep 14, 2006.


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