Parental vaccine safety concerns - The experiences of pediatricians and family physicians
Parental vaccine safety concerns - The experiences of pediatricians and family physicians
复制标题
DOI：
10.1016/j.amepre.2003.09.004
复制
发表时间：
2004-01-01
影响因子：
5.5
通讯作者：
Santoli, JM
中科院分区：
文献类型：
--
作者：
Freed, GL;Clark, SJ;Santoli, JM
目的：最近，关于疫苗安全性的几个问题受到了媒体的广泛关注。初级保健医生是最常见的接口与免疫接种系统的父母，很可能有最大的机会接触和经验与父母的疫苗safety concerns.Methods：邮件调查研究的国家随机抽样的750名儿科医生（PD）和750名家庭医生（FP）在2000年进行。主要关注的结果变量包括过去一年中父母拒绝接种疫苗的数量，特定父母疫苗安全性问题的频率，以及当父母拒绝接种疫苗时医生采取的行动。卡方分析用于确定每个关注的结果变量与医生专业、疫苗拒绝频率和人口统计学变量之间的关联的显著性。多变量分析探讨了潜在的独立预测医生谁经历了疫苗拒绝增加。结果：应答率为70%。总体而言，93%的PD和60%的FP报告在过去一年中至少有一次父母拒绝接种疫苗。PD也比FP更有可能报告过去一年中疫苗拒绝数量的增加（18%对8%，p = 0.01），而FP更有可能报告同一时期疫苗拒绝数量的减少（18%对11%; p < 0.5）。PD比FP更有可能向拒绝接种疫苗的父母提供有关疫苗的额外信息和/或在以后的访视中讨论该问题。父母最常见的问题是有关的短期反应和疼痛，从多次injection.Conclusions：虽然几乎所有的PD和大多数FP经历了至少一个疫苗拒绝从父母在过去的一年中，少得多的医生，这两个专业观察到他们的发生率增加。医生必须努力始终充分了解免疫接种的好处以及父母对疫苗安全性的关注。
Objectives: Recently several concerns regarding vaccine safety have received significant media attention. Primary care physicians are the most common interface for parents with the immunization delivery system and are likely to have the greatest opportunity for exposure and experience with parental vaccine safety concerns.Methods: Mail survey study of a national random sample of 750 pediatricians (PDs) and 750 family physicians (FPs) was conducted in 2000. Outcome variables of primary interest included the number of parental vaccine refusals in the past year, frequency of specific parent vaccine safety concerns, and actions taken by physicians when parents refused a vaccine. Chi-square analysis was used to determine the significance of the association of each outcome variable of interest with physician specialty, frequency of vaccine refusal, and the demographic variables. Multivariate analysis explored the potential for independent predictors of physicians who experienced increases in vaccine refusal.Results: The response rate was 70%. Overall, 93% of PDs and 60% of FPs reported at least one parental vaccine refusal in their practice in the past year. PDs also were more likely than FPs to report an increase in the number of vaccine refusals over the past year (18% v 8%, p = 0.01), while FPs were more likely to report a decrease in vaccine refusals over the same time period (18% v 11%; p < 0.5). PDs were more likely than FPs to provide additional information regarding vaccines to parents who refused vaccines and/or to discuss the issue at later visits. The most common concerns of parents were related to short-term reactions and pain from multiple injections.Conclusions: While almost all PDs and most FPs experienced at least one vaccine refusal from parents in the past year, far fewer physicians of both specialties observed an increase in their occurrence. Physicians must work to be consistently well informed of both the benefits of immunization as well as the issues of parental concern regarding vaccine safety.