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Hepatitis B vaccine use in Cincinnati: a community's response to the AAP recommendation of universal hepatitis B
R M Siegel1, R C Baker, U R Kotagal
1Division of General Pediatrics, Children's Hospital Medical Center, Cincinnati, OH 45229.
Insights
Pediatricians and family practitioners show low approval for universal infant hepatitis B virus (HBV) immunization. Many express concerns about cost and scientific evidence, indicating poor anticipated compliance with AAP recommendations.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- The American Academy of Pediatrics (AAP) Committee on Infectious Diseases recommended universal infant immunization against hepatitis B virus (HBV).
- Physician acceptance and anticipated compliance are crucial for the success of public health immunization recommendations.
Purpose of the Study:
- To assess pediatricians' and family practitioners' approval of the AAP's universal infant HBV immunization recommendation.
- To determine anticipated compliance rates with the HBV immunization policy among healthcare providers.
Main Methods:
- A survey questionnaire was distributed to pediatricians and family practitioners with admitting privileges at a specific institution.
- Response rates were 47% for pediatricians (n=205) and 38% for family practitioners (n=86).
- The survey collected data on current HBV immunization practices, future strategies, and opinions on the AAP recommendation.
Main Results:
- Only 21% of pediatricians and 12.5% of family practitioners planned to vaccinate all infants.
- A significant portion (22% of pediatricians, 28% of family practitioners) intended to offer the vaccine only to those who could afford it.
- Approval of the AAP recommendation was low: 42.6% for pediatricians and 36.4% for family practitioners.
Conclusions:
- Widespread concern exists among local practitioners regarding the financial feasibility and scientific justification of universal infant HBV immunization.
- Anticipated compliance with the AAP's universal HBV immunization recommendation is expected to be low in this community.
- Physician attitudes and practical concerns significantly influence the adoption of public health immunization guidelines.
Abstract:
The Committee on Infectious Diseases of the American Academy of Pediatrics (AAP) recently recommended universal immunization of infants against hepatitis B virus (HBV). We surveyed all pediatricians and family practitioners with admitting privileges to our institution to determine their degree of approval of the AAP recommendation and the anticipated compliance with the recommendation. A questionnaire was sent to 86 family practitioners and 205 pediatricians; the response rate was 38% and 47%, respectively. The survey sought information regarding prior HBV immunization practices, planned HBV immunization strategies in the physician's office and hospital nursery, and the individual's opinion of the AAP recommendation. Only 21% of pediatricians and 12.5% of family practitioners anticipated giving HBV vaccine to all infants. An additional 22% of pediatricians and 28% of family practitioners planned to give HBV vaccine to infants who had the means to pay for the vaccine. Only a minority of physicians, 42.6% of pediatricians and 36.4% of family practitioners, approved of the AAP recommendation. We conclude that in our community there is widespread concern about the financial practicality and scientific merit of universal HBV immunization, and many practitioners will not comply with the AAP recommendation.