Pediatricians achieve higher influenza vaccination rates than family physicians

BOSTON — Compared with family physicians, pediatricians offered influenza vaccine for a longer time during influenza season and administered the vaccine more frequently during sick visits, according to a study presented here.

Perspective from Richard Lander, MD

According to findings from an abstract presented during the 2012 Pediatric Academic Societies Annual Meeting, pediatrician offices began the vaccination of children against influenza 3 weeks earlier than family physician offices and ended 1.5 weeks later. In addition, pediatricians were more likely to administer influenza vaccine during sick visits (15% vs. 10%; P<.05). Pediatrician offices also more commonly employed standing orders and reminder systems.

To get a better understanding of these differences which have been demonstrated in the past with other childhood vaccines, Seth L. Toback, MD, director of medical affairs, MedImmune, and colleagues conducted a prospective, observational study that compared pediatric influenza vaccination practices of US pediatricians and family physicians during the 2010 to 2011 influenza season. The investigators enrolled a random sample of 105 pediatrician and 13 family physician offices in the study.

According to the findings, pediatricians had a higher vaccination coverage rate for all children 6 months through 18 years of age (24% vs. 14%) for at least one dose of vaccine, and both pediatricians and family physicians had similar compliance (56% vs. 57%) with the recommended two-dose regimen for previously unvaccinated children aged 6 months to 8 years of age.

In addition, pediatrician offices started influenza vaccination 3 weeks earlier and ended 1.5 weeks later compared with family physician offices (239 vs. 212 days; P=.003). Both specialties utilized well visits to administer the vaccine with 55% and 40% of all doses being delivered in this setting by family physicians and pediatricians, respectively, but pediatricians were more likely to give influenza vaccinations during sick visits (15% vs. 10%; P<0.05).

Toback said that 80% of pediatricians vs. 45% of family physicians used preservative-free vaccine when vaccinating children 6 to 23 months, and 46% of pediatricians used the intranasal vaccine vs. 20% of family physicians when vaccinating children 2 to 18 years of age. The authors concluded that a greater understanding of the different vaccination habits between the two specialties could help to create strategies to improve vaccination in all children.

For more information:

Toback SL. #2915.214. Presented at: 2012 PAS Annual Meeting; April 28-May 1, 2012; Boston.

Disclosure: Dr .Toback is employed by MedImmune. The study was sponsored by MedImmune.

Perspective

Richard Lander, MD

The abstract pointed at the differences between pediatricians and family physicians. Pediatricians receive 3 years of pediatric training as compared to the 6 months that the family physicians receive in pediatric training. We have the concept of vaccinating children at every opportunity drilled into us. We actually use the term of “lost or missed opportunity” when a child isn’t caught up on their vaccination schedule at any visit to our offices, sick or well. According to the data presented, that was where the pediatricians and family physicians differed significantly.

A problem, though, is there were very few family physician practices that responded to the surveys, which might have skewed the results. The high rate of return among pediatricians might be either a personal relationship with the author or just the fact that he is a pediatrician.

Richard Lander, MD

Infectious Diseases in Children Editorial Board

Disclosures: Dr. Lander is the co-owner of the National Discount Vaccine Alliance.