HOW IMPORTANT IS EARLY-CHILDHOOD HEPATITIS-B VACCINATION - A SURVEY OF PRIMARY-CARE PHYSICIANS

BACKGROUND. Although early childhood hepatitis B vaccination rates hav e risen dramatically in the United States, there are still areas with low rates. Understanding the barriers to vaccination as perceived by p rimary care physicians is key to raising rates in such areas. METHODS. A stratified random sample of family physicians, pediatricians, and g eneral practitioners-younger than age 65 and having office-based pract ices across the United States-was selected from the American Medical A ssociation physician list, including nonmembers. A standardized teleph one survey was conducted by trained interviewers in 1995. Physicians s eeing 5 or more patients younger than age 6 per week and having a prac tice comprising greater than or equal to 50% primary care patients wer e eligible. RESULTS. Most physicians (78%) rated the importance of hep atitis B vaccine as high. Based on regression analyses, the primary de terminants of the importance of hepatitis B vaccine were: no stated co ncerns about its routine use (odds ratio [OR] = 2.8; 95% confidence in terval [CI], 1.7 - 4.7), low disease incidence/importance in the pract ice (OR = .33; 95% CI, .18 - .60), preference for administering hepati tis B vaccine during adolescence (OR = .36; 95% CI, .18 - .72), specia lty as family physician (OR = .36; 95% CI, .23 -.57), and specialty as general practitioner (OR = .37; 95% CI, .21 - .63). CONCLUSIONS. Most primary care physicians recommend hepatitis B vaccination, although a number of concerns exist. Given that only 4 years had elapsed from th e lime of the new recommendations for routine early childhood hepatiti s B vaccination in 1991 until this survey, remarkable progress has bee n made.