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Parent-requested delays in pediatric vaccinations require intervention
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Many pediatricians and family physicians report receiving parental requests to spread out children’s immunization schedules, and despite concerns, agree to do so, according to study findings in Pediatrics.
These results indicate a need for evidence-based interventions to increase timely immunization.
“A recent national survey in the United States demonstrated that 13% of parents of young children reported using some type of alternative vaccination schedule,” Allison Kempe, MD, MPH, of Children’s Hospital Colorado in Aurora, Colorado, and colleagues wrote. “Such alternative schedules can lead to underimmunization, which has been shown to significantly increase the risk of acquiring and transmitting vaccine-preventable diseases.”
Allison Kempe
As part of the CDC’s Vaccine Policy Collaborative Initiative, Kempe and colleagues administered surveys to pediatric and family physicians from June to November 2012. The final study cohort included 282 pediatricians and 252 family physicians.
Ninety-three percent of physicians reported that in a typical month, some parents of children aged younger than 2 years requested spreading out vaccines. Twenty-three percent reported an increase in these parental requests compared with previous years, and 40% of respondents said this decreased their job satisfaction.
Most participants agreed it was important that all vaccines in the primary series be administered on time (92%), that parents who chose to spread out vaccines were increasing their child’s risk for contracting disease (87%), and that it was more painful for children to bring them back for separate injections (84%).
Eighty-two percent of physicians, however, reportedly believed that if they agreed to spread out vaccines, it would build trust with families, and 80% believed it might keep patients from leaving the practice.
Thirty-seven percent of physicians reported often/always agreeing to spread out vaccines when requested, 37% reported agreeing sometimes and 26% reported rarely agreeing.
More pediatricians than family physicians (57% vs. 34%; P < .001) reported spending more than 10 minutes discussing immunizations with vaccine-hesitant parents.
“Our study points out the need for an evidence base to guide primary care physicians in efforts to increase timely vaccination,” Kempe and colleagues wrote. “Given the amount of time discussions with vaccine-hesitant parents take, the inability to charge for extra visits focusing solely on such discussions, and competing demands in primary care, interventions that supplement the limited communication that can occur at well-child visits are also needed.”
Disclosure: The researchers report no relevant financial disclosures.
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