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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Physician Response to Parental Requests to Spread Out the Recommended Vaccine Schedule

Allison Kempe, Sean T. O’Leary, Allison Kennedy, Lori A. Crane, Mandy A. Allison, Brenda L. Beaty, Laura P. Hurley, Michaela Brtnikova, Andrea Jimenez-Zambrano and Shannon Stokley
Pediatrics April 2015, 135 (4) 666-677; DOI: https://doi.org/10.1542/peds.2014-3474
Allison Kempe
aChildren’s Outcomes Research, Children’s Hospital Colorado, Aurora, Colorado;
bDepartment of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado;
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Sean T. O’Leary
aChildren’s Outcomes Research, Children’s Hospital Colorado, Aurora, Colorado;
bDepartment of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado;
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Allison Kennedy
cNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Lori A. Crane
aChildren’s Outcomes Research, Children’s Hospital Colorado, Aurora, Colorado;
dDepartment of Community and Behavioral Health, Colorado School of Public Health, Denver, Colorado; and
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Mandy A. Allison
aChildren’s Outcomes Research, Children’s Hospital Colorado, Aurora, Colorado;
bDepartment of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado;
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Brenda L. Beaty
aChildren’s Outcomes Research, Children’s Hospital Colorado, Aurora, Colorado;
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Laura P. Hurley
aChildren’s Outcomes Research, Children’s Hospital Colorado, Aurora, Colorado;
eDivision of General Internal Medicine, Denver Health, Denver, Colorado
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Michaela Brtnikova
aChildren’s Outcomes Research, Children’s Hospital Colorado, Aurora, Colorado;
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Andrea Jimenez-Zambrano
aChildren’s Outcomes Research, Children’s Hospital Colorado, Aurora, Colorado;
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Shannon Stokley
cNational Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Abstract

OBJECTIVES: To assess among US physicians (1) frequency of requests to spread out recommended vaccination schedule for children <2 years, (2) attitudes regarding such requests, and (3) strategies used and perceived effectiveness in response to such requests.

METHODS: An e-mail and mail survey of a nationally representative sample of pediatricians and family physicians from June 2012 through October 2012.

RESULTS: The response rate was 66% (534 of 815). In a typical month, 93% reported some parents of children <2 years requested to spread out vaccines; 21% reported ≥10% of parents made this request. Most respondents thought these parents were putting their children at risk for disease (87%) and that it was more painful for children (84%), but if they agreed to requests, it would build trust with families (82%); further, they believed that if they did not agree, families might leave their practice (80%). Forty percent reported this issue had decreased their job satisfaction. Most agreed to spread out vaccines when requested, either often/always (37%) or sometimes (37%); 2% would often/always, 4% would sometimes, and 12% would rarely dismiss families from their practice if they wanted to spread out the primary series. Physicians reported using a variety of strategies in response to requests but did not think they were effective.

CONCLUSIONS: Virtually all providers encounter requests to spread out vaccines in a typical month and, despite concerns, most are agreeing to do so. Providers are using many strategies in response but think few are effective. Evidence-based interventions to increase timely immunization are needed to guide primary care and public health practice.

  • immunizations
  • vaccine hesitancy
  • vaccine refusal
  • risk and benefit communication
  • provider survey
  • Accepted January 28, 2015.
  • Copyright © 2015 by the American Academy of Pediatrics

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Pediatrics
Vol. 135, Issue 4
1 Apr 2015
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Physician Response to Parental Requests to Spread Out the Recommended Vaccine Schedule
Allison Kempe, Sean T. O’Leary, Allison Kennedy, Lori A. Crane, Mandy A. Allison, Brenda L. Beaty, Laura P. Hurley, Michaela Brtnikova, Andrea Jimenez-Zambrano, Shannon Stokley
Pediatrics Apr 2015, 135 (4) 666-677; DOI: 10.1542/peds.2014-3474

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Physician Response to Parental Requests to Spread Out the Recommended Vaccine Schedule
Allison Kempe, Sean T. O’Leary, Allison Kennedy, Lori A. Crane, Mandy A. Allison, Brenda L. Beaty, Laura P. Hurley, Michaela Brtnikova, Andrea Jimenez-Zambrano, Shannon Stokley
Pediatrics Apr 2015, 135 (4) 666-677; DOI: 10.1542/peds.2014-3474
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