Physician attitudes and preferences about combined Tdap vaccines for adolescents
Physician attitudes and preferences about combined Tdap vaccines for adolescents
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DOI：
10.1016/j.amepre.2006.03.023
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发表时间：
2006-08-01
影响因子：
5.5
通讯作者：
Clark, Sarah J.
中科院分区：
文献类型：
--
作者：
Davis, Matthew M.;Broder, Karen R.;Clark, Sarah J.
背景资料：联合破伤风类毒素，减少白喉类毒素，和无细胞百日咳疫苗（Tdap）的青少年助推器是一种新的战略，以预防百日咳。我们检查了儿科医生和家庭医生关于青少年破伤风和白喉类毒素（Td）疫苗免疫接种的现行做法，以及供应商对青少年Tdap新建议的潜在遵守情况。使用一个简短的调查工具发送给随机抽样的儿科医生和家庭医生在2005年1月，我们评估了供应商的管理模式的TD助推器，障碍TD助推器，并同意青少年接种百日咳疫苗是必要的。2005年2月的分析结果提交给咨询委员会的免疫实践的疾病控制和预防中心（CDC），告知其审议关于青少年Tdap vaccination.Results：总体应答率为56%（57%儿科医生，55%家庭医生）。在297名受访者中，（154名儿科医生，143名家庭医生）符合分析条件，因为他们为青少年提供护理，儿科医生（77%）明显比家庭医生更有可能（51%，p < 0.0001）报告他们在11至12岁青少年的预防保健访视中常规使用Td，但除此之外，这些专业在TD实践中是相似的。44%的受访者认为青少年就诊不频繁是TD免疫接种的障碍。略多于一半的样本（57%）同意或强烈同意百日咳严重到足以保证青少年用Tdap取代Td;儿科医生（70%）比家庭医生更有可能（42%，p < 0.0001）支持这一说法。这项全国性调查表明，儿科医生比家庭医生更愿意支持青少年Tdap的建议。2006年2月，疾病预防控制中心发布了建议，11至18岁（首选11至12岁）的青少年接受一次Tdap关闭，以取代TD，如果他们还没有接受后者。关于Tdap建议的近期努力必须解决提供者对青少年不经常常规就诊的担忧，并说服更多的医生在青少年期间进行百日咳加强免疫的重要性。
Background: Combined tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) boosters for adolescents are a new strategy to prevent pertussis. We examined the current practices of pediatricians and family physicians regarding adolescent tetanus and diphtheria toxoids (Td) vaccine immunizations and providers' potential adherence to new Tdap recommendations for adolescents.Methods: Using a brief survey instrument sent to a random sample of pediatricians and family physicians in January 2005, we assessed providers' patterns of administration of Td boosters, barriers to Td boosters, and agreement that pertussis vaccination of adolescents is warranted. Results of analyses in February 2005 were presented to the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC) to inform its deliberations regarding adolescent Tdap vaccination.Results: The overall response rate was 56% (57% pediatricians, 55% family physicians). Among 297 respondents (154 pediatricians, 143 family physicians) eligible for analysis because they provide care to adolescents, pediatricians (77%) were significantly more likely than family physicians (51%, p < 0.0001) to report that they routinely administer Td at preventive care visits for adolescents aged 11 to 12 years, but otherwise the specialties were similar in their Td practices. Forty-four percent of respondents cited infrequency of adolescent visits as a barrier to Td immunization. Slightly more than half the sample (57%) agreed or strongly agreed that pertussis is serious enough to warrant replacing Td with Tdap for adolescents; pediatricians (70%) were significantly more likely than family physicians (42%, p < 0.0001) to endorse this statement.Conclusions: This national survey indicates moderate willingness, stronger among pediatricians than among family physicians, to support recommendations for Tdap among adolescents. In February 2006, CDC released recommendations that adolescents aged 11 to 18 (preferred age 11 to 12) receive a single close of Tdap in place of Td if they have not already received the latter. Near-term efforts regarding Tdap recommendations must address providers' concerns about infrequent routine visits for adolescents and convince more physicians of the importance of pertussis booster immunization during adolescence.