The rotavirus vaccine's withdrawal and physicians' trust in vaccine safetymechanisms

Objective: To determine how the withdrawal from the market of the rotavirus vaccine has affected physicians' trust in vaccine safety mechanisms, futur e adherence to vaccine recommendations, and willingness to use a new rotavi rus vaccine. Design: National survey mailed to 1228 randomly selected pediatricians and family physicians. Main Outcome Measures: Confidence in vaccine safety mechanisms was defined by agreement with the statements that the system for determining vaccine sa fety before a vaccine is licensed works well and that the system for monito ring vaccine safety after vaccine licensure works well. Physicians who indi cated that they would use a new rotavirus vaccine within 1 year of licensur e and recommendation by professional organizations were classified as "earl y adopters." Logistic regression was used to assess the relationship betwee n trust in vaccine safety mechanisms and future early adoption of new rotav irus vaccines. Results: Following the withdrawal of the rotavirus vaccine, 83% of responde nts believed the postlicensure surveillance system works well to monitor va ccine safety, while 22% of respondents believed the prelicensure system wor ks well to determine vaccine safety. After adjusting for physician specialt y and years in practice, respondents who believed the prelicensure vaccine safety system works well were significantly more likely to be early adopter s than those with less confidence in prelicensure studies (adjusted odds ra tio, 2.2 [95% confidence interval, 1.3-3.6]). Conclusions: Physicians have different levels of trust in prelicensure stud ies that determine vaccine safety and postlicensure surveillance systems th at monitor vaccine safety. Trust in prelicensure vaccine safety evaluations may be associated with early adherence to new vaccine recommendations.