Practices of family physicians and pediatricians in administering poliovirus vaccine

BACKGROUND. When the Advisory Committee on Immunization Practices added the sequential schedule to the poliovirus vaccine (PVV) recommendations in 199 7, primary care physicians expressed concern about its implementation. This study examines the practices and factors influencing the administration of sequential, oral, or inactivated PW schedules by family physicians and ped iatricians. METHODS. A random sample of Ohio family physicians and pediatricians was su rveyed between January and April 1998, Primary outcome measures included ph ysicians' awareness of the 1997 recommendations, their recommendations to p arents and caregivers, administration of current PW options, and the factor s influencing their practices. RESULTS. All physicians who immunize children (n = 263) reported awareness of the 1997 PW recommendations. Family physicians were more likely to recom mend and administer oral polio vaccine than pediatricians (50% and 63% vs 1 7% and 28%; P <.001). Pediatricians were more likely to recommend and admin ister the sequential schedule than family physicians (66% and 67% vs 31% an d 28%; P <.001). Choice of sequential schedule was related to the risk of v accine-associated paralytic poliomyelitis and liability (P less than or equ al to.05). Choice of an all oral polio vaccine schedule was related to cost of inactivated PW and increased number of injections (P less than or equal to.05). One hundred eighty-two physicians (69%) indicated that they person ally discuss PW options with parents or caregivers; only 41% have them read the required vaccine information sheets. CONCLUSIONS. Differences exist between family physicians' and pediatricians ' implementation of the 1997 PW recommendations. Physician choice of PVV sc hedule is influenced by the risk of vaccine-associated paralytic poliomyeli tis, increased number of injections, liability concerns, and Vaccine cost. Physicians need to inform parents of vaccine benefits and risks to comply w ith federal regulations.