Combination vaccines: practical considerations for public health and private practice.
BACKGROUND
Although the current immunization schedule for children requires as many as four or five injections at a single visit, both parents and health care providers hesitate to administer more than two or three simultaneous injections. Therefore new combination vaccines that include multiple unrelated antigens are needed.


METHODS
Individuals from the Immunization Division of the Colorado State Department of Health and pediatricians in private practice in Denver, CO, were interviewed and asked about incorporating new combination vaccines into their practice.


RESULTS
At a state health department level the transition to combination vaccines will likely require reprioritizing of public health resources. In addition state health officials are important information resources for public and private providers, as well as for the community. At the level of the private provider combination vaccines hold promise for simplifying the immunization schedule, but successful implementation will require education and guidance on how best to integrate the new combination into practice.


CONCLUSIONS
Combination vaccines are the immediate solution to the addition of new childhood vaccines and will alleviate the concern of parents and physicians regarding the trauma related to multiple injections at a single visit.
Glodé
M P
MP
Department of Pediatrics, The Children's Hospital, Denver, CO 80218, USA. glode.mary@tchden.org
D003120:Colorado; D006801:Humans; D010372:Pediatrics; D011331:Private Practice / Q000592:standards*; D011634:Public Health / Q000592:standards*; D011795:Surveys and Questionnaires; D014611:Vaccination; D017778:Vaccines, Combined / Q000008:administration & dosage / Q000592:standards
D017778:Vaccines, Combined