Groom Holly, Bhatt Achal, Washington Michael L, Santoli Jeanne
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Pediatrics. 2008 Oct;122(4):e835-40. doi: 10.1542/peds.2008-1092.
Heptavalent pneumococcal conjugate vaccine was in short supply from December 2003 to August 2004. The Centers for Disease Control and Prevention with the American Academy of Pediatrics and the American Academy of Family Physicians made recommendations to providers to withhold third and fourth doses of heptavalent pneumococcal conjugate vaccine to ensure availability for those at highest risk. Previous studies of vaccine shortages have demonstrated that provider compliance with temporary recommendations is low. The objective of this study was to collect timely data about awareness and adherence to temporary recommendations and current supply status of heptavalent pneumococcal conjugate vaccine in pediatric practices.
A 2-phase telephone survey of pediatric practices was conducted during a 10-week period during the 2003-2004 heptavalent pneumococcal conjugate vaccine shortage. Immunization nurses at randomly selected sites with physician-members of the American Academy of Pediatrics were asked a series of questions.
In both study phases, >90% of participating practices were aware of the recommendations and reported adhering to the recommendations. In phase 1, practices with insufficient supply were more likely to implement recommendations than practices with sufficient supply. Participants identified health departments and Wyeth Vaccines as the most common sources of information. At least 65% of the practices in each phase reported use of tracking systems for children who missed doses.
Most pediatric practices surveyed were aware of the shortage and were implementing the heptavalent pneumococcal conjugate vaccine recommendations. Simplified recommendations and collaborative efforts to develop and widely disseminate interim recommendations may result in increased compliance by providers.
2003年12月至2004年8月期间,七价肺炎球菌结合疫苗供应短缺。疾病控制与预防中心联合美国儿科学会和美国家庭医师学会向医疗服务提供者提出建议,暂停接种第三剂和第四剂七价肺炎球菌结合疫苗,以确保高危人群能够获得该疫苗。以往关于疫苗短缺的研究表明,医疗服务提供者对临时建议的依从性较低。本研究的目的是及时收集有关儿科诊所对七价肺炎球菌结合疫苗临时建议的知晓情况、依从情况以及当前供应状况的数据。
在2003 - 2004年七价肺炎球菌结合疫苗短缺的10周期间,对儿科诊所进行了两阶段电话调查。随机选取美国儿科学会医生会员所在机构的免疫接种护士,询问了一系列问题。
在两个研究阶段,超过90%的参与诊所知晓这些建议,并报告称遵守了这些建议。在第一阶段,疫苗供应不足的诊所比供应充足的诊所更有可能执行这些建议。参与者将卫生部门和惠氏疫苗公司列为最常见的信息来源。在每个阶段,至少65%的诊所报告使用了针对漏种疫苗儿童的追踪系统。
接受调查的大多数儿科诊所知晓疫苗短缺情况,并正在执行七价肺炎球菌结合疫苗的相关建议。简化建议以及共同努力制定并广泛传播临时建议可能会提高医疗服务提供者的依从性。