Educating physicians on current influenza recommendations may increase coverage rates

WASHINGTON — Keeping physicians up-to-date with information about the influenza vaccine recommendations of the Advisory Committee on Immunization Practices affects immunization rates, according to new findings presented here.

Results of a new study from the CDC indicate that provider outreach and education should continue because ensuring physician knowledge of current ACIP influenza vaccination recommendations may increase vaccination recommendations to patients. Previous research has shown that a physician recommendation for vaccination is strongly associated with getting vaccinated.

The latest change in influenza immunization recommendations — stating that everyone aged at least 6 months be vaccinated — was published just before the start of influenza season in August, and many physicians may not have been aware of the change.

Therefore, Carla Black, PhD,epidemiologist at the CDC, and colleagues assembled a panel in September to examine physicians’ knowledge of recent ACIP recommendations and physician characteristics associated with recommending influenza vaccination.

The study, a cross-sectional online survey, consisted of 493 pediatricians, obstetrician/gynecologists, internists and family/general practitioners from the American Medical Association’s master file and other lists. The panelists were asked the following questions:

Which patients were included in the 2010 ACIP influenza vaccination recommendation?
Which patients will they recommend vaccination to in the 2010-11 influenza season?
Do they receive annual influenza immunization?
What are their beliefs about influenza immunization?

Black and colleagues found that 64% of physicians surveyed knew that all patients aged at least 6 months were recommended for vaccination. However, 49% of physicians incorrectly believed that children aged younger than 6 months were recommended for vaccination.

“We recruited nearly equal numbers of each specialty, but when we weighted the estimates, internists and general/family practitioners accounted for the majority of the sample. Most of the respondents work on a group setting, were male and between the ages of 40 and 49 years, and were white or of another race, mostly Asian,” Black said during her presentation at the 45th Annual National Immunization Conference.

Of the physicians who treat adults, 62% indicated that they recommend influenza vaccination to all adults. In multivariable analysis, physician characteristics significantly associated with correctly recommending vaccination to adults included knowledge of ACIP recommendations (OR=8.6; 95% CI, 4.8-15.4) and personal vaccination during the 2009-2010 season (OR=3.3; 95% CI, 1.3-8.7).

Among the physicians who treat children, 78% indicated that they recommend influenza vaccination to all children aged at least 6 months. Knowledge of ACIP recommendations (OR=5.8; 95% CI, 2.4-14.5) and personal vaccination (OR=6.2; 95% CI, 2.2-17.8) were also significantly associated with recommending vaccination to children based on current ACIP recommendations.

Pediatricians were more likely (OR=3.6; 95% CI, 1.2-10.6) and internists less likely (OR=0.2; 95% CI, 0.1-0.6) to recommend vaccination to children compared with family/general practitioners.

“Pediatricians are more likely than other specialties to know about new recommendations for children,” Black said.

Logistic regression modeling was used to determine physician characteristics associated with recommending influenza vaccination.

For more information:

Black C. #25537. Presented at: the 45th Annual National Immunization Conference; March 28-31, 2011; Washington D.C.

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