Varicella immunization practices and the factors that influence them.
Varicella immunization practices and the factors that influence them.
复制标题
水痘免疫实践及其影响因素。
DOI：
10.1001/archpedi.153.4.357
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发表时间：
1999
影响因子：
--
通讯作者：
S. Bruno
中科院分区：
文献类型：
--
作者：
S. Schaffer;S. Bruno
目标
评估纽约州罗切斯特市医生的水痘免疫实践，并确定预测医生是否为儿童接种水痘疫苗的因素。
设计
评价一项针对水痘免疫实践和水痘免疫意见的40项调查，该调查发送给241名儿科医生和家庭医生。
结果
共有172名医生（71.4%）完成了调查。63%的人将疫苗接种给部分或所有1至5岁的水痘易感儿童，57%的人将疫苗接种给6至11岁的儿童，74%的人将疫苗接种给12岁及以上的青少年。没有提供免疫接种的医生更有可能认为：（1）不应该给青春期前的儿童接种疫苗，因为“水痘是儿童期的正常部分”;（2）通过接种疫苗，水痘可能从主要是儿童疾病转变为主要是成人疾病;（3）儿童已接受足够的免疫接种，不应再接受额外的免疫接种以预防水痘;（4）只为免疫力低下的人士及其密切接触者进行免疫接种可能更为可取;以及（5）为所有没有患过水痘的美国儿童接种疫苗的成本太高。最有可能提供疫苗的医生是儿科医生和那些病人主要由私人保险计划覆盖的医生。在了解到水痘相关并发症的发病率和死亡率后，许多不接种疫苗或仅在父母要求下接种疫苗的医生表示，他们更有可能提供疫苗。
结论
罗切斯特地区的大多数医生都接种水痘疫苗，特别是12岁及以上的青少年。专业，主要的保险类型计费，和各种意见的特点，那些谁没有提供免疫接种。向这些医生提供有关水痘相关并发症的信息可能会使他们更有可能免疫。
OBJECTIVES
To evaluate the varicella immunization practices of physicians in Rochester, NY, and to identify factors that predict whether physicians administer varicella vaccine to children.
DESIGN
Evaluation of a 40-item survey addressing varicella immunization practices and opinions about varicella immunization that was sent to 241 pediatricians and family physicians.
RESULTS
A total of 172 physicians (71.4%) completed the survey. Sixty-three percent administer the vaccine to some or all varicella-susceptible children aged 1 through 5 years, while 57% administer it to children aged 6 through 11 years, and 74% administer it to adolescents 12 years and older. Physicians who did not offer the immunization were more likely to believe that (1) the vaccine should not be given to preadolescent children because "varicella is a normal part of childhood"; (2) by giving the vaccine, varicella may shift from being primarily a childhood illness to being primarily an adult illness; (3) children get enough immunizations already and should not be given additional immunizations to prevent varicella; (4) it may be preferable to only immunize immunocompromised individuals and their close contacts; and (5) it would cost too much to immunize all American children who have not had varicella. Physicians most likely to offer the vaccine were pediatricians and those whose patients were covered primarily by private insurance plans. After becoming aware of morbidity and mortality rates for varicella-related complications, many physicians who did not administer the vaccine, or administered it only at the request of a parent, indicated that they would be more likely to offer it.
CONCLUSIONS
Most physicians in the Rochester area administer varicella vaccine, especially to adolescents 12 years and older. Specialty, predominant insurance type billed, and various opinions characterized those who did not offer the immunization. Providing these physicians with information about varicella-related complications may make them more likely to immunize.