Humiston Sharon G, Szilagyi Peter G, Iwane Marika K, Schaffer Stanley J, Santoli Jeanne, Shone Laura, Barth Richard, McInerny Thomas, Schwartz Benjamin
New Vaccine Surveillance Network, Department of Rochester, 601 Elmwood Avenue, NY 14642, USA.
Arch Pediatr Adolesc Med. 2004 Sep;158(9):867-74. doi: 10.1001/archpedi.158.9.867.
Physicians' opinions on the feasibility of routine influenza vaccination of infants and toddlers are unknown.
To assess the opinions of primary care providers regarding (1) the feasibility of an expanded influenza vaccination recommendation, (2) potential barriers, and (3) current and projected use of immunization reminder systems for influenza vaccination.
In February 2001, we mailed a 20-item, self-administered survey to a national random sample of pediatricians and family physicians (FPs). The survey primarily focused on a scenario of routine influenza vaccination for children aged 12 through 35 months using either injected or intranasal spray vaccine.
Four hundred fifty-eight eligible physicians completed the survey (eligible response rate: pediatricians, 72%; FPs, 52%). Regarding the scenario mentioned above, most physicians agreed that implementation would be feasible (pediatricians, 80%; FPs, 69%); would significantly decrease illness visits during influenza season (pediatricians, 67%; FPs, 57%); and was justified by influenza's severity and complications (pediatricians, 61%; FPs, 41%). When considering a scenario that extended down to 6 months of age and only allowed use of injectable vaccine for infants, fewer physicians (pediatricians, 50%; FPs, 40%) considered implementation feasible. The issues most frequently cited as important potential barriers for practices were costs (77%), vaccine safety issues (52%), and the inability to identify eligible children (46%).
To make widespread implementation feasible, the following are needed: minimizing costs for families and physician practices, educational campaigns on key issues, and primary care system changes (eg, tracking of eligible children, reminder and/or recall systems, and immunization clinics).
医生对于婴幼儿常规流感疫苗接种可行性的看法尚不清楚。
评估初级保健提供者对于(1)扩大流感疫苗接种建议的可行性、(2)潜在障碍以及(3)流感疫苗接种免疫提醒系统的当前及预期使用情况的看法。
2001年2月,我们向全国随机抽取的儿科医生和家庭医生邮寄了一份包含20个问题的自填式调查问卷。该调查主要聚焦于为12至35个月大的儿童使用注射或鼻喷疫苗进行常规流感疫苗接种的情况。
458名符合条件的医生完成了调查(符合条件的回复率:儿科医生为72%;家庭医生为52%)。对于上述情况,大多数医生认为实施是可行的(儿科医生为80%;家庭医生为69%);会显著减少流感季节的患病就诊次数(儿科医生为67%;家庭医生为57%);并且鉴于流感的严重性和并发症,这样做是合理的(儿科医生为61%;家庭医生为41%)。当考虑将接种范围扩大到6个月大且仅允许为婴儿使用注射疫苗的情况时, fewer physicians(此处英文有误,应改为fewer physicians)认为实施可行的医生较少(儿科医生为50%;家庭医生为40%)。被认为是重要潜在障碍的问题最常提到的是成本(77%)、疫苗安全问题(52%)以及无法识别符合条件的儿童(46%)。
为使广泛实施可行,需要做到以下几点:将家庭和医生诊疗的成本降至最低、开展关于关键问题的教育活动以及改变初级保健系统(例如,追踪符合条件的儿童、提醒和/或召回系统以及免疫接种诊所)。