University of Maryland Department of Pediatrics, 737 W. Lombard Street, Baltimore, MD 21201, USA.
Pediatrics. 2012 Mar;129 Suppl 2:S96-S100. doi: 10.1542/peds.2011-0737I.
Vaccinating all children aged 6 months to 18 years every year has potentially large ramifications for office-based primary care pediatricians. We determined the degree to which pediatricians support routine annual influenza vaccination outside the medical home, especially in school-located mass influenza vaccination clinics.
Internet-based survey sent in May and June 2009 to all 623 currently practicing primary care general pediatricians who were members of the Maryland Chapter of the American Academy of Pediatrics.
Of those surveyed, 193 (31%) responded. Approximately 67% reported they vaccinated more than half the children in their practice with at least one dose in the 2008-2009 influenza season, and about half anticipated that, in their office, they would not attain ≥75% coverage of all patients older than 5 months of age. Approximately 27% of respondents predicted they would likely have difficulty obtaining sufficient vaccine to cover commercially insured patients, and 32% were likely to have difficulty getting sufficient vaccine to cover Medicaid, underinsured, and uninsured patients because of ordering or distribution problems. Approximately 78% of respondents cited borderline or poor reimbursement for influenza vaccinations, and 53% had unused vaccine at the end of the 2008-2009 influenza season. Ninety-six percent of respondents supported school-located influenza vaccination programs in their community for their patients.
These results indicate awareness by primary care pediatricians in Maryland of the potential difficulties involved in implementing universal influenza vaccinations in their practice and their support of school-located vaccination programs managed by the local health department in their community.
每年为所有 6 个月至 18 岁的儿童接种疫苗,这对以初级保健为基础的儿科医生可能会产生巨大影响。我们确定了儿科医生在医疗家庭之外支持常规年度流感疫苗接种的程度,特别是在学校集中流感疫苗接种诊所。
2009 年 5 月至 6 月,我们通过互联网向马里兰州儿科学会的所有 623 名在职普通儿科医生进行了调查。
在接受调查的医生中,有 193 人(31%)做出了回应。大约 67%的人报告说,在 2008-2009 流感季节,他们为实践中超过一半的儿童接种了至少一剂疫苗,大约一半的人预计在他们的办公室,他们将无法达到所有 5 个月以上患者的覆盖率≥75%。约 27%的受访者预测,由于订购或分发问题,他们可能难以获得足够的疫苗来覆盖商业保险患者,而 32%的人可能难以获得足够的疫苗来覆盖医疗补助、保险不足和无保险患者。约 78%的受访者表示流感疫苗接种的报销情况处于边缘或较差水平,53%的人在 2008-2009 流感季节结束时仍有未使用的疫苗。96%的受访者支持其所在社区为患者提供学校集中流感疫苗接种计划。
这些结果表明,马里兰州的初级保健儿科医生意识到在实践中实施普遍流感疫苗接种所涉及的潜在困难,并支持其所在社区的地方卫生部门管理的学校集中疫苗接种计划。