Physician knowledge of catch-up regimens and contraindications for childhood immunizations.
OBJECTIVE
To determine physician success at designing catch-up regimens for children delayed in immunizations and physician knowledge regarding contraindications to immunization.


METHODS
A self-administered survey was completed by pediatricians, general practitioners, and family practitioners in Cook County, Illinois. Surveys included 6 open-ended vignettes describing hypothetical children delayed in immunization for whom participants were asked to design catch-up regimens. Bivariate and multivariate logistic regression were used to determine predictors of correct response. The surveys also inquired about management of scenarios that might be perceived as contraindications to immunize with the Haemophilus influenzae type b or measles-mumps-rubella vaccines.


RESULTS
The mean score of correct responses was 1.83 of a possible 6.0. Almost one third of respondents answered all 6 vignettes incorrectly. The proportion of incorrect responses was high for all 6 vignettes (39%-86%), but higher for questions that addressed the immunization of children older than 12 months. Errors in vaccine administration were most commonly attributed to omitted vaccines, with varicella-zoster vaccine and pneumococcal conjugate vaccine omitted most frequently. Pediatricians were >4 times more likely to answer correctly than were family practitioners. Participants in the Vaccines for Children (VFC) program were more than twice as likely to answer correctly than were non-VFC providers. Knowledge of contraindications was inconsistent, particularly for measles-mumps-rubella vaccine.


CONCLUSIONS
Childhood vaccine providers have substantial knowledge deficits of recommended immunization schedules and vaccine contraindications that may contribute to missed opportunities to immunize. Pediatricians and participants in the VFC program were more successful at designing catch-up regimens for children with immunization delay.
Pediatric Immunization Program, the Department of Pediatrics, University of Chicago, Chicago, Illinois, USA.
Nicole J
NJ
Cohen
Diane S
DS
Lauderdale
Priya B
PB
Shete
John B
JB
Seal
Robert S
RS
Daum
D000367:Age Factors; D000574:American Medical Association; D002675:Child, Preschool; D002983:Clinical Competence; D000075202:Contraindications; D016208:Databases, Factual; D005260:Female; D018073:Haemophilus Vaccines / Q000009:adverse effects; D019741:Haemophilus influenzae type b / Q000276:immunology; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000009:adverse effects; D010372:Pediatrics / Q000592:standards; D010821:Physicians, Family / Q000592:standards; D014481:United States; D014611:Vaccination / Q000379:methods*
D018073:Haemophilus Vaccines; D022542:Measles-Mumps-Rubella Vaccine