title: Knowledge and recommendation regarding routine childhood vaccinations among pediatric healthcare providers in Israel.
abstract: A recommendation by pediatric healthcare providers (HCPs) is a major factor influencing parents' decision to vaccinate their children. Consequently, it is important to understand the motives behind the HCPs' recommendations to vaccinate children according to the routine immunization program.
  
  
  
  To study the association of pediatric HCPs' knowledge about and attitudes towards childhood vaccinations and of their professional and demographic characteristics, with two variables: 1. Their recommendations to parents regarding adherence to the routine immunization program. 2. Their choices concerning routine immunization of their own children.
  
  
  
  We conducted a cross-sectional study of pediatric nurses and physicians working at Mother-Child Health Clinics (MCHCs) in Haifa and Tel-Aviv districts and at a hospital in Hadera City, Israel.
  
  
  
  A structured, anonymous self-administered questionnaire was used.
  
  
  
  The overall response rate was 60%, totaling 218 participants. 92% of whom were nurses. Misconceptions related to vaccine safety were found among a high percentage of the participants. The HCPs knowledge level was associated with the HCPs vaccinating their own children according to the recommended immunization program (OR=1.32; CI95% 1.06-1.64), but not with their recommendation to parents to adhere to the program. No association was found between attitudes and these variables. Workplace (MCHCs versus hospital) correlated with the above mentioned two dependent variables (OR=1.89; CI95% 1.21-2.97 and OR=2.42; CI95% 1.73-3.4, respectively).
  
  
  
  Amplifying the knowledge of HCPs and addressing their concern about vaccinations can improve their adherence to the routine immunization program regarding their own children. This may lead to better adherence of other parents who are frequently interested in the HCPs' behavior and consider them as a role model. In general, there is a need to emphasize the HCP's responsibility for the successful implementation of the immunization program in the community and at hospitals.
authors.affiliation: Haifa District Health Office, Government Complex, Palyam Ave. 15a, P.O. Box 800, Haifa 31999, Israel. Electronic address: rana.shibly@lbhaifa.health.gov.il.
authors.forename: Rana
authors.initials: R
authors.lastname: Shibli
authors.affiliation: Haifa District Health Office, Government Complex, Palyam Ave. 15a, P.O. Box 800, Haifa 31999, Israel.
authors.forename: Rivka
authors.initials: R
authors.lastname: Shemer
authors.affiliation: Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, 1 Emek HaElah St., Ramat Gan 5262160, Israel; School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel.
authors.forename: Liat
authors.initials: L
authors.lastname: Lerner-Geva
authors.affiliation: Haifa District Health Office, Government Complex, Palyam Ave. 15a, P.O. Box 800, Haifa 31999, Israel; School of Public Health, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, Haifa 349883, Israel.
authors.forename: Shmuel
authors.initials: S
authors.lastname: Rishpon
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs; D007115:Immunization Schedule; D007557:Israel; D008297:Male; D008875:Middle Aged; D000072222:Nurses, Pediatric / Q000523:psychology*; D000072143:Pediatricians / Q000523:psychology*; D010372:Pediatrics; D011361:Professional Competence; D014611:Vaccination / Q000523:psychology*
keywords: Attitude; Childhood vaccination; Healthcare provider; Knowledge