Davis Matthew M, Kretsinger Katrina, Cowan Anne E, Stokley Shannon, Clark Sarah J
Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan 48109-0456, USA.
Hum Vaccin. 2007 Jul-Aug;3(4):130-4. doi: 10.4161/hv.3.4.4307. Epub 2007 Apr 8.
Availability of combined tetanus-diphtheria-acellular pertussis (Tdap) vaccines for adults offers a new pertussis prevention strategy for the US. Successful uptake of Tdap vaccine will depend partly on the attitudes and practices of primary care physicians, including their experience with Td boosters. We conducted a mail survey in August 2005 of a national random sample of 399 family physicians (FPs) and 399 general internists (IMs) to assess practices related to Td boosters, clinical experience with pertussis, and attitudes toward a potential Tdap vaccine recommendation for adults. The response rate was 49% (52% FPs, 46% IMs). Among 336 eligible respondents, half reported having clinical experience with pertussis. Most (81%) would recommend Tdap vaccine for their adult patients, and 73% support targeting adults likely to come in close contact with infants. Attitudes toward a potential Tdap vaccine recommendation differed by whether providers stock and administer Td boosters. We conclude that adult primary care providers in the US are likely to recommend Tdap vaccine to their adult patients, in concordance with recent national recommendations. Future research should assess the extent to which barriers impede adoption of Tdap vaccine recommendations.
成人用破伤风-白喉-无细胞百日咳(Tdap)联合疫苗的出现为美国提供了一种新的百日咳预防策略。Tdap疫苗的成功推广将部分取决于初级保健医生的态度和做法,包括他们使用破伤风类毒素(Td)加强针的经验。2005年8月,我们对全国399名家庭医生(FPs)和399名普通内科医生(IMs)进行了随机抽样邮件调查,以评估与Td加强针相关的做法、百日咳的临床经验以及对向成人推荐Tdap疫苗可能性的态度。回复率为49%(家庭医生为52%,普通内科医生为46%)。在336名合格受访者中,一半报告有百日咳临床经验。大多数(81%)会向成年患者推荐Tdap疫苗,73%支持针对可能与婴儿密切接触的成年人。对Tdap疫苗推荐可能性的态度因提供者是否储备和使用Td加强针而有所不同。我们得出结论,美国的成人初级保健提供者可能会按照近期的国家建议,向成年患者推荐Tdap疫苗。未来的研究应评估阻碍采用Tdap疫苗推荐的障碍程度。