Immunization Barriers: A Study of Generalist Physicians. Abstract, Executive211 Summary and Final Report

摘要

To understand barrier to childhood immunization, we conducted a national survey211u001ein 1995 of 1,236 primary care physicians using computer-assisted telephone 211u001einterviewing. Half (47%) the respondents were less likely to vaccinate a child in 211u001ethe acute-care setting as compared to the well-child visit, and 52% treated the 211u001esituations equally, suggesting that this is one barrier. Some physicians were 211u001eoverly cautious when interpreting contraindications. The majority (58%) reported 211u001ethat they would be likely to refer an uninsured child to a public health vaccine 211u001eclinic but were unlikely to refer an insured child. Almost all (90%) on the 211u001ephysicians who do not receive free vaccine supplies were likely to refer an 211u001euninsured, poor child whereas 44% of those who receive free vaccine supplies were 211u001elikely to refer. We conducted a second study comparing provider responses with 211u001eimmunization data from children they vaccinated. A greater percentage of children 211u001ewere vaccinated on-time among providers that received free vaccine as compared to 211u001echildren seen by providers who did not receive free vaccines: 77% versus 48% for 211u001eMMR and 82% versus 66% for DTP no. 4.