Schaffer S J, Bruno S
Strong Children's Research Center, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, NY, USA.
Arch Pediatr Adolesc Med. 1999 Apr;153(4):357-62. doi: 10.1001/archpedi.153.4.357.
To evaluate the varicella immunization practices of physicians in Rochester, NY, and to identify factors that predict whether physicians administer varicella vaccine to children.
Evaluation of a 40-item survey addressing varicella immunization practices and opinions about varicella immunization that was sent to 241 pediatricians and family physicians.
A total of 172 physicians (71.4%) completed the survey. Sixty-three percent administer the vaccine to some or all varicella-susceptible children aged 1 through 5 years, while 57% administer it to children aged 6 through 11 years, and 74% administer it to adolescents 12 years and older. Physicians who did not offer the immunization were more likely to believe that (1) the vaccine should not be given to preadolescent children because "varicella is a normal part of childhood"; (2) by giving the vaccine, varicella may shift from being primarily a childhood illness to being primarily an adult illness; (3) children get enough immunizations already and should not be given additional immunizations to prevent varicella; (4) it may be preferable to only immunize immunocompromised individuals and their close contacts; and (5) it would cost too much to immunize all American children who have not had varicella. Physicians most likely to offer the vaccine were pediatricians and those whose patients were covered primarily by private insurance plans. After becoming aware of morbidity and mortality rates for varicella-related complications, many physicians who did not administer the vaccine, or administered it only at the request of a parent, indicated that they would be more likely to offer it.
Most physicians in the Rochester area administer varicella vaccine, especially to adolescents 12 years and older. Specialty, predominant insurance type billed, and various opinions characterized those who did not offer the immunization. Providing these physicians with information about varicella-related complications may make them more likely to immunize.
评估纽约州罗切斯特市医生的水痘免疫接种情况，并确定预测医生是否为儿童接种水痘疫苗的因素。
对一份包含40个项目的调查问卷进行评估，该问卷涉及水痘免疫接种情况及对水痘免疫接种的看法，已发送给241名儿科医生和家庭医生。
共有172名医生（71.4%）完成了调查。63%的医生为部分或全部1至5岁易患水痘的儿童接种疫苗，57%的医生为6至11岁儿童接种，74%的医生为12岁及以上青少年接种。未提供免疫接种的医生更有可能认为：（1）不应给青春期前儿童接种疫苗，因为“水痘是儿童成长的正常部分”；（2）接种疫苗后，水痘可能从主要是儿童疾病转变为主要是成人疾病；（3）儿童已经接种了足够的疫苗，不应再额外接种以预防水痘；（4）可能最好只对免疫功能低下的个体及其密切接触者进行免疫接种；（5）为所有未患过水痘的美国儿童接种疫苗成本太高。最有可能提供疫苗的医生是儿科医生以及那些患者主要由私人保险计划承保的医生。在了解水痘相关并发症的发病率和死亡率后，许多未接种疫苗或仅应家长要求接种疫苗的医生表示，他们更有可能提供疫苗。
罗切斯特地区的大多数医生接种水痘疫苗，尤其是为12岁及以上青少年接种。专业领域、主要计费保险类型以及各种观点是未提供免疫接种医生的特征。向这些医生提供有关水痘相关并发症的信息可能会使他们更有可能进行免疫接种。
