Flu vaccination adherence: Pediatricians vs. family medicine docs

May 3, 2008

It’s been over four years since the Advisory Committee on Immunization Practices (ACIP) influenza vaccine recommendations were expanded to include six-23-month-olds, and two years since the recommended expansion for 24-59-month-olds. So how diligent have pediatricians and family medicine (FM) docs been in applying these recommendations? A study by researchers at the University of Colorado, Denver School of Medicine, found that adherence among pediatricians has been almost universal, with family medicine docs trailing behind. Using responses to e-mail and mailed surveys, researchers found that 95% of peds surveyed routinely vaccinated six-23 month olds for the flu, with only 72% of FM docs routinely vaccinating patients in this age group. Surprisingly, in the 24-59 month old age group, adherence among peds was 80%, with only 42% of FM docs vaccinating this group.

It’s been over four years since the Advisory Committee on Immunization Practices (ACIP) influenza vaccine recommendations were expanded to include six-23-month-olds,and two years since the recommended expansion for 24-59-month-olds. So how diligenthave pediatricians and family medicine (FM) docs been in applying these recommendations?A study by researchers at the University of Colorado, Denver School of Medicine,found that adherence among pediatricians has been almost universal, with familymedicine docs trailing behind. Using responses to e-mail and mailed surveys, researchersfound that 95% of peds surveyed routinely vaccinated six-23 month olds for theflu, with only 72% of FM docs routinely vaccinating patients in this age group.Surprisingly, in the 24-59 month old age group, adherence among peds was 80%,with only 42% of FM docs vaccinating this group.

Factors reported as barriers to implementing the new recommendations for 24-59month olds include concerns about having enough vaccine supply (Peds 48%, FM 47%),parental doubts about the necessity of vaccination in this age group (Peds 35%,FM 45%), concerns about insurance coverage (Peds 27%, FM 34%), ability of thepractice to handle the increased time and resources required (Peds 24%, FM 25%),the need to educate parents regarding the new recommendations (Peds 19%, FM 39%)andnot seeing 24-59 month olds frequently enough (Peds 13%, FM 32%). Lead researcherAllison Kempe cautioned, however, that this is not a case of “Pediatriciansare good, family medicine docs are bad.” Indeed, these results may be morereflective of the fact that family medicine docs may simply be more overwhelmedwith the demands of their practice, treating not only children, but adult andelderly patients as well.