title: Physician attitudes regarding breakthrough varicella disease and a potential second dose of varicella vaccine.
abstract: OBJECTIVE
  We assessed physicians' attitudes about the 1-dose varicella vaccination program and whether physicians think a 2-dose recommendation is needed to reduce the risk of breakthrough disease.
  
  
  METHODS
  We conducted a national mail survey of a random sample of 550 pediatricians and 550 family physicians from April to June 2005. Physicians who provide outpatient primary care to children < or = 6 years of age were eligible for analysis.
  
  
  RESULTS
  Surveys were returned by 727 respondents, for a response rate of 69%; 610 physicians were eligible. Most respondents (94%) recommend routine 1-dose varicella vaccination, and 79% have seen breakthrough disease in the past 5 years (95% of pediatricians and 58% of family physicians). The majority (68%) agreed or strongly agreed that the current burden of breakthrough disease is acceptable. Only 38% (46% of pediatricians and 28% of family physicians) agreed or strongly agreed that a second dose of varicella vaccine is needed to address the burden of breakthrough disease, whereas 40% were neutral. However, if the Advisory Committee on Immunization Practices were to recommend a second dose of varicella vaccine, then 65% of pediatricians and 39% of family physicians would likely follow the recommendation. Most respondents (78%) would be more willing to recommend a second dose if a combination measles-mumps-rubella-varicella vaccine was available.
  
  
  CONCLUSIONS
  Pediatricians and family physicians support the 1-dose varicella vaccination program. A new Advisory Committee on Immunization Practices recommendation for a second dose of varicella vaccine for children was issued after the survey (in June 2006). Two of 3 pediatricians and 2 of 5 family physicians stated that they would adopt a 2-dose recommendation in practice; rates of adoption may be bolstered with current availability of measles-mumps-rubella-varicella vaccine and harmonization of the varicella vaccination schedule with that of measles-mumps-rubella vaccine.
authors.affiliation: Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, MI, USA. mattdav@med.umich.edu
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Davis
authors.forename: Mona
authors.initials: M
authors.lastname: Marin
authors.forename: Anne E
authors.initials: AE
authors.lastname: Cowan
authors.forename: Dalya
authors.initials: D
authors.lastname: Guris
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Clark
mesh_terms: D001291:Attitude of Health Personnel; D002644:Chickenpox / Q000517:prevention & control*; D019433:Chickenpox Vaccine / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D010820:Physicians; D011795:Surveys and Questionnaires
chemical_list: D019433:Chickenpox Vaccine