title: Late-season influenza vaccination: a national survey of physician practice and barriers.
abstract: BACKGROUND
  Although late-season influenza vaccination has been recently promoted, existing data suggest it occurs infrequently.
  
  
  OBJECTIVE
  This study aims to describe among primary care physicians: (1) late-season vaccination practices; (2) perceived barriers; and (3) factors associated with late-season influenza vaccination in a year when vaccine supplies are inadequate or delayed.
  
  
  METHODS
  A survey administered March 2007-June 2007 to 1268 primary care providers in a national survey network. Data analysis was completed in 2009.
  
  
  RESULTS
  Overall response rate was 74% (n=940). Seventy-one percent of respondents reported vaccinating until February/March when there were adequate vaccine supplies and 84% reported vaccinating until February/March when vaccine supplies were inadequate or delayed. Perceived barriers to late-season vaccination included difficulty administering a second dose in children if the first was given late in the season (91% of respondents); providers/patients forgetting about vaccination (77%); and concern about having unused vaccine left at the end of a season (74%). Physicians who reported vaccinating into February/March when vaccine supplies were inadequate or delayed more often reported believing late-season vaccination is clinically beneficial, experiencing difficulty persuading patients to accept late-season vaccination, forgetting about the need for vaccination, not being able to meet demand for influenza vaccine and experiencing high patient volumes during winter months.
  
  
  CONCLUSIONS
  Most physicians appear willing to perform late-season vaccination despite existing data demonstrating that it occurs infrequently. Efforts to increase late-season vaccination should address vaccine supply issues, late-season influenza vaccine reminders, and patient and provider education on its clinical benefits.
authors.affiliation: Department of Pediatrics, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA. Christina.suh@ucdenver.edu
authors.forename: Christina
authors.initials: C
authors.lastname: Suh
authors.forename: Lon
authors.initials: L
authors.lastname: McQuillan
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Daley
authors.forename: Lori A
authors.initials: LA
authors.lastname: Crane
authors.forename: Brenda
authors.initials: B
authors.lastname: Beaty
authors.forename: Jennifer
authors.initials: J
authors.lastname: Barrow
authors.forename: Christine
authors.initials: C
authors.lastname: Babbel
authors.forename: L Miriam
authors.initials: LM
authors.lastname: Dickinson
authors.forename: Allison
authors.initials: A
authors.lastname: Kempe
mesh_terms: D003625:Data Collection; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000600:supply & distribution; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012621:Seasons; D014481:United States
chemical_list: D007252:Influenza Vaccines