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Pediatricians' vaccine attitudes and practices before and after a major measles outbreak
Salini Mohanty1, Alison M Buttenheim1, Kristen A Feemster2
11 School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
Insights
The Disneyland measles outbreak did not significantly alter pediatricians' vaccine attitudes. However, it prompted some to adjust office policies and immunization practices, with fewer requests for alternative schedules post-outbreak.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- The 2015 Disneyland measles outbreak highlighted vaccine hesitancy concerns.
- Understanding pediatrician responses to public health crises is crucial for vaccine promotion.
Purpose of the Study:
- To assess the impact of the Disneyland measles outbreak on pediatricians' vaccine attitudes and practices.
- To evaluate changes in pediatrician willingness to delay the measles-mumps-rubella (MMR) vaccine and office policies.
Main Methods:
- Three repeated cross-sectional online surveys were conducted among pediatricians in 2014, 2015, and 2016.
- Pediatricians' comfort with delaying MMR vaccination, alternative schedule requests, and office policies were assessed before and after the outbreak.
Main Results:
- No significant changes were observed in pediatricians' willingness or comfort in delaying the MMR vaccine.
- Following the outbreak, 38% reported fewer requests for alternative immunization schedules, and 20% implemented stricter office immunization policies.
- Some pediatricians administered the MMR vaccine earlier and enhanced waiting room precautions.
Conclusions:
- The measles outbreak had a modest impact on pediatric office immunization policies and practices, rather than significant shifts in attitudes.
- Pediatricians' core vaccine attitudes remained largely unchanged despite the public health event.
Abstract:
The objective of this study was to describe how a sample of pediatricians were impacted by and responded to the Disneyland measles outbreak in the United States. We conducted three repeated cross-sectional, online surveys in 2014 (before the outbreak), 2015, and 2016 (after the outbreak) among members of three state chapters of the American Academy of Pediatrics. We assessed pediatricians' level of willingness and length of time comfortable delaying the measles-mumps-rubella (MMR) vaccine before and after the outbreak. Frequency of alternative immunization schedule requests and creation of office immunization policies due to the outbreak were measured. The sample included 304 pediatricians in 2014, 270 in 2015, and 221 in 2016. We found no significant changes in willingness or comfort delaying the MMR vaccine before and after the outbreak. In 2015, 38% of pediatricians reported fewer requests for alternative immunization schedules and 20% created stricter office immunization policies. A subsample of pediatricians reported administering the MMR vaccine earlier in the recommended time frame and taking extra precautions in waiting rooms due to the outbreak. Our results suggest that this measles outbreak did not lead to significant changes in attitudes or practices among this sample, but did modestly affect office immunization policies and practices.