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Published online April 19, 2010
PEDIATRICS Vol. 125 No. 5 May 2010, pp. 914-920 (doi:10.1542/peds.2009-1710)
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ARTICLES

Knowledge of Interim Recommendations and Use of Hib Vaccine During Vaccine Shortages

Allison Kempe, MD, MPHa,b,c, Christine Babbel, MSPHb,c, Gregory S. Wallace, MD, MS, MPHd, Shannon Stokley, MPHd, Matthew F. Daley, MDa,b,c, Lori A. Crane, PhD, MPHc,e, Brenda Beaty, MSPHb,c, Sandra R. Black, DVMb,c, Jennifer Barrow, MSPHb,c, L. Miriam Dickinson, PhDf

Departments of a Pediatrics and
f Family Medicine and
b Colorado Health Outcomes Program, University of Colorado, Denver, Colorado;
c Children's Outcomes Research Program, Children's Hospital, Aurora, Colorado;
d Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and
e Department of Preventive Medicine and Biometrics, Colorado School of Public Health, Aurora, Colorado

OBJECTIVES The goals were to determine among pediatricians and family physicians (1) knowledge of interim recommendations regarding Haemophilus influenzae type b (Hib) vaccine administration, (2) current practices, and (3) factors associated with nonadherence.

METHODS An Internet-based survey was conducted in April 2008 among national samples.

RESULTS Response rates were 68% (220 of 325 physicians) among pediatricians and 51% (153 of 302 physicians) among family physicians. Seventy-three percent of pediatricians and 45% of family medicine physicians reported insufficient Hib vaccine supplies, and 22% to 24% reported having to defer doses for infants 2 to 6 months of age ≥10% of the time. Ninety-eight percent of pediatricians and 81% of family physicians were aware of the interim recommendations (P ≤ .0001), and virtually all knew that the booster dose should be deferred; however, 22% of pediatricians and 33% of family medicine physicians reported not deferring this dose. Physicians in both specialties were less likely to adhere to recommendations to defer in this age group if they thought that their practice had sufficient vaccine supplies (pediatricians, odds ratio: 0.01 [95% confidence interval: 0.003–0.03]; family medicine physicians, odds ratio: 0.10 [95% confidence interval: 0.03–0.33]). Family medicine physicians were less likely to adhere to recommendations if they had not heard about the interim recommendations (odds ratio: 0.04 [95% confidence interval: 0.01–0.21]).

CONCLUSIONS Most primary care physicians experienced Hib vaccine shortages, and many have had to defer doses for 2- to 6-month-old children. Most are knowledgeable regarding interim recommendations, but one-fifth to one-third reported nonadherence.

Key Words: child immunization • Haemophilus influenzae type b recall • Haemophilus influenzae type b shortage • physician practices • survey

Abbreviations: Hib = Haemophilus influenzae type b • AAP = American Academy of Pediatrics • AAFP = American Academy of Family Physicians • ACIP = Advisory Committee on Immunization Practices • CDC = Centers for Disease Control and Prevention • VFC = Vaccines for Children • PCV7 = heptavalent pneumococcal conjugate vaccine

Accepted Dec 11, 2009.


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