title: Physicians' early challenges related to the pneumococcal conjugate vaccine.
abstract: OBJECTIVE
  To characterize the obstacles faced by physicians regarding administration of a 7-valent pneumococcal conjugate vaccine (Prevnar) to all children younger than 2 years and to high-risk children from 2--5 years of age during the months immediately following national recommendations.
  
  
  METHODS
  Semistructured telephone interviews.
  
  
  METHODS
  Convenience sample (n = 24) of pediatricians and family physicians.
  
  
  RESULTS
  Eighteen physicians were recommending pneumococcal vaccine and 6 were not. Those who were recommending pneumococcal vaccine had encountered resistance from parents and variations in private and public insurance coverage. Physicians who were not recommending pneumococcal vaccine expressed concern about the cost of the vaccine and general caution in adopting new vaccine recommendations. Respondents offered several suggestions for improving the vaccine recommendation process.
  
  
  CONCLUSIONS
  This analysis of physicians' early decision making regarding pneumococcal vaccine reflects obstacles to vaccine implementation that may arise with the introduction of other childhood vaccines.
authors.affiliation: Division of General Pediatrics, Child Health Evaluation and Research Unit, University of Michigan, Ann Arbor 48109-0456, USA. mattdav@med.umich.edu
authors.forename: M M
authors.initials: MM
authors.lastname: Davis
authors.forename: M
authors.initials: M
authors.lastname: Andreae
authors.forename: G L
authors.initials: GL
authors.lastname: Freed
mesh_terms: D000328:Adult; D002675:Child, Preschool; D003657:Decision Making; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D007114:Immunization / Q000191:economics; D007223:Infant; D019458:Insurance Coverage; D022401:Meningococcal Vaccines / Q000191:economics; D008824:Michigan; D022242:Pneumococcal Vaccines / Q000191:economics; D010818:Practice Patterns, Physicians'; D018074:Vaccines, Conjugate / Q000191:economics
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022401:Meningococcal Vaccines; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate