title: The missing link: family physician perspectives on barriers and enablers to prescribing a new Meningococcal B vaccine and other recommended, non-government funded vaccines.
abstract: OBJECTIVE
  To determine factors influencing Family Physician (FP) uptake of non government-funded vaccines, and to explore FP attitudes towards the introduction and use of a new vaccine to protect against serogroup B meningococcal disease to inform its future introduction into the Australian Immunisation Schedule.
  
  
  METHODS
  Quantitative, self-administered state-wide questionnaire mailed to all FPs in South Australia (n=1786). Results from 523 FP respondents in South Australia, collected between June and October 2013.
  
  
  METHODS
  Self-reported immunisation counselling practices; and knowledge, attitudes and barriers to prescribing of Meningococcal B (Men B) vaccine and other recommended, non-funded immunisations.
  
  
  RESULTS
  The response rate was 30% (n=523). While most (59%) respondents had worked in general practice for over 20 years, only 39% of all respondents had ever had personal or professional experience with a case of invasive meningococcal disease (IMD). Most FPs (63%) were aware that a meningococcal B vaccine was being developed, and 93% of respondents agreed that this vaccine should be government-funded. FPs ranked Men B vaccine as the highest priority to receive funding of eight currently non-funded immunisation strategies. High vaccine cost and low patient socioeconomic status were identified as definite barriers to prescribing non-funded vaccines by 59% of respondents. Past IMD experience significantly affected attitudes and prescribing practices.
  
  
  CONCLUSIONS
  IMD, while encountered rarely in clinical practice, is considered an important disease to vaccinate against by FPs. Cost and perceived low socioeconomic status of patients are substantial barriers to FPs prescribing Men B and other non-funded vaccines, and inclusion of such vaccines on the National Immunisation Program is likely to improve equity of access.
authors.affiliation: School of Population Health, University of Adelaide, South Australia, Australia; Vaccinology and Immunology Research Trials Unit (VIRTU), University of Adelaide, Women's and Children's Hospital, South Australia, Australia. Electronic address: kathryn.taylor@adelaide.edu.au.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Taylor
authors.affiliation: School of Population Health, University of Adelaide, South Australia, Australia.
authors.forename: Nigel
authors.initials: N
authors.lastname: Stocks
authors.affiliation: School of Population Health, University of Adelaide, South Australia, Australia; Vaccinology and Immunology Research Trials Unit (VIRTU), University of Adelaide, Women's and Children's Hospital, South Australia, Australia.
authors.forename: Helen S
authors.initials: HS
authors.lastname: Marshall
mesh_terms: D001291:Attitude of Health Personnel; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs; D008297:Male; D008589:Meningococcal Infections / Q000517:prevention & control; D022401:Meningococcal Vaccines / Q000627:therapeutic use*; D010821:Physicians, Family / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013021:South Australia; D011795:Surveys and Questionnaires
chemical_list: D022401:Meningococcal Vaccines
keywords: Attitudes; Equity; Family physicians; Meningococcal; Meningococcal B vaccine; Public health; Vaccination