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Published online October 12, 2009
PEDIATRICS Vol. 124 No. 5 November 2009, pp. e809-e816 (doi:10.1542/peds.2008-3832)
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ARTICLE

Adoption of Rotavirus Vaccination by Pediatricians and Family Medicine Physicians in the United States

Allison Kempe, MD, MPHa,b,c,d, Manish M. Patel, MD, MSe, Matthew F. Daley, MDa,c,d, Lori A. Crane, PhD, MPHb,d, Brenda Beaty, MSPHc,d, Shannon Stokley, MPHf, Jennifer Barrow, MSPHc,d, Christine Babbel, MSPHc,d, L. Miriam Dickinson, PhDg, Jonathan L. Tempte, MD, PhDh, Umesh D. Parashar, MBBS, MPHe

Departments of a Pediatrics
g Family Medicine, School of Medicine
b Departments of Health Systems Management and Policy and Community and Behavioral Health, Colorado School of Public Health
c Colorado Health Outcomes Program, University of Colorado Denver, Aurora, Colorado
d Children's Outcomes Research Program, Children's Hospital, Aurora, Colorado
e 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
h Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin

OBJECTIVES: The goals were to assess, among pediatricians and family medicine physicians, (1) rates of offering the vaccine in their office; (2) knowledge of Advisory Committee on Immunization Practices recommendations; (3) barriers to use; and (4) factors associated with offering the vaccine.

METHODS: Surveys of pediatricians and family medicine physicians were conducted in August to October 2007.

RESULTS: Response rates were 84% for pediatricians and 79% for family medicine physicians (N = 623). Proportions routinely offering the vaccine were 85% of pediatricians and 45% of family medicine physicians (P < .0001); 70% of pediatricians and 22% of family medicine strongly recommended the vaccine (P < .0001). Sixty-two percent of pediatricians and 32% of family medicine physicians (P < .0001) knew the age by which all 3 doses should be completed. Definite barriers to vaccine use included reported lack of coverage by insurance companies (family medicine physicians: 22%; pediatricians: 19%; not significant), costs of purchasing vaccine (family medicine physicians: 22%; pediatricians: 17%; not significant), lack of adequate reimbursement (family medicine physicians: 18%; pediatricians: 15%; not significant), concerns about safety (family medicine physicians: 25%; pediatricians: 9%; P < .0001), and concerns about adding another vaccine to the schedule (family medicine physicians: 22%; pediatricians: 5%; P < .0001).

CONCLUSIONS: Rates of offering the new rotavirus vaccine are high among pediatricians but <50% among family medicine physicians. Both specialties identified financial barriers to use of the vaccine, but family medicine physicians had significantly more concerns about safety and about adding another vaccine to the vaccination schedule.

Key Words: immunization • rotavirus vaccine • physician attitudes

Abbreviations: AAP—American Academy of Pediatrics • ACIP—Advisory Committee on Immunization Practices • PCV7—heptavalent pneumococcal conjugate vaccine • AAFP—American Academy of Family Physicians

Accepted Jun 4, 2009.


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