title: Varicella immunisation practice: Implications for provision of a recommended, non-funded vaccine.
abstract: OBJECTIVE
  In Australia in 2003 a two-tiered immunisation schedule was introduced consisting of funded (National Immunisation Program) and non-funded but recommended vaccines (Best Practice Schedule), including varicella vaccine. The aim of this study was to examine immunisation practice when a vaccine is recommended but not funded by Government.
  
  
  METHODS
  A survey was sent to 600 randomly selected general practitioners (GPs) in South Australia between June and August 2005, prior to provision of Federal funding for varicella vaccine.
  
  
  RESULTS
  Although varicella was considered an important disease to prevent by 89% of GPs, only 25% of GPs always discussed the non-funded immunisation with parents at the time of a routine immunisation visit. Female GPs were more likely to discuss immunisation with recommended, non-funded vaccines than male GPs. Those who were supportive of varicella prevention were more likely to discuss immunisation with the non-funded vaccine. GPs who always provided information about the disease were more likely to have parents accept their advice about varicella vaccine (62.7%) than those who never provided information (40%). GPs reported parental refusal of varicella vaccine was due to the cost and perception that varicella is a mild disease.
  
  
  CONCLUSIONS
  The results of this study showed variability in prescribing practices for a non-funded vaccine. Recommending a vaccine without provision of funding may lead to 'mixed messages' for immunisation providers and parents with resultant low coverage. Funding a vaccine is likely to reduce variability in provision of the vaccine and improve coverage in the community.
authors.affiliation: Department of Paediatrics, Women's and Children's Hospital, North Adelaide, SA, Australia. helen.marshall@adelaide.edu.au
authors.forename: Helen
authors.initials: H
authors.lastname: Marshall
authors.forename: Philip
authors.initials: P
authors.lastname: Ryan
authors.forename: Don
authors.initials: D
authors.lastname: Roberton
authors.forename: Justin
authors.initials: J
authors.lastname: Beilby
mesh_terms: D000367:Age Factors; D002644:Chickenpox / Q000191:economics / Q000517:prevention & control*; D019433:Chickenpox Vaccine / Q000008:administration & dosage / Q000191:economics*; D005194:Family Practice / Q000191:economics / Q000379:methods; D005260:Female; D005380:Financing, Government; D005382:Financing, Personal; D019983:Guideline Adherence / Q000191:economics; D019538:Health Care Surveys; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000191:economics; D013021:South Australia
chemical_list: D019433:Chickenpox Vaccine