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Physician concerns about vaccine adverse effects and potential litigation
R K Zimmerman1, J J Schlesselman, T A Mieczkowski
1Department of Family Medicine and Clinical Epidemiology, School of Medicine, University of Pittsburgh, Pa., USA. zimmer+@pitt.edu
Archives of Pediatrics & Adolescent Medicine
|February 7, 1998
Summary
Physician concerns about vaccine litigation are influenced by perceived risks of adverse effects and confidence in the Vaccine Injury Compensation Program. These concerns can impact immunization recommendations, though most physicians still encourage vaccination.
Area of Science:
- Medical research
- Public health
- Immunization practices
Background:
- Physician perceptions of vaccine safety and litigation risks are crucial for understanding immunization hesitancy.
- The Vaccine Injury Compensation Program (VICP) aims to protect healthcare providers from litigation, but its perceived effectiveness varies.
- Accurate risk assessment of vaccine adverse events is essential for informed clinical decision-making.
Purpose of the Study:
- To investigate the relationship between physician concerns regarding litigation and their beliefs about vaccine safety.
- To assess how physicians perceive the liability protection offered by the Vaccine Injury Compensation Program.
- To determine the impact of litigation concerns on physicians' likelihood to administer specific immunizations.
Main Methods:
- A national survey of 1236 family physicians, pediatricians, and general practitioners was conducted in 1995.
- The survey utilized standardized telephone interviews to gather data on physician beliefs and concerns.
- Eligibility criteria included physicians seeing at least 5 young children weekly and having a majority of primary care patients.
Main Results:
- A significant percentage of physicians overestimated serious adverse event risks for pertussis (32%) and measles (13%) vaccines.
- Higher perceived likelihood of serious adverse effects correlated with increased concern about vaccine litigation (P < .01).
- Physicians concerned about litigation were less likely to recommend the third dose of DTP vaccine for a child with a fever (22% vs. 12%, P < .05).
Conclusions:
- Physicians' perceptions of vaccine risks and VICP protection significantly influence their litigation concerns.
- These concerns, in turn, affect their reported likelihood of administering immunizations.
- Despite concerns, most physicians (86%) encourage vaccination even when parents raise objections about adverse effects.