One-Year Uptake of Pneumococcal Conjugate Vaccine: A National Survey of Family Physicians and Pediatricians

Article Figures & Data

Table 1.

Practice Characteristics of Physician Respondents

Practice Characteristic	Pediatricians (n = 435) (%)	Family Physicians (n = 259) (%)	P Value
Ownership of practice
University	4	3	> .8
Hospital	12	15
Physician network^*	11	10
Public	3	4
Independent private	69	68
Other	1	0
Number of physicians in practice
1	17	22	< .01
2–3	23	32
4–5	23	15
6–9	18	17
≥10	19	14
Proportion of patients on Medicaid
<10%	37	46	< .05
10%–40%	36	36
41%–70%	17	12
>70%	10	6
Proportion of patients who are African American
<10%	55	69	= .001
10%–40%	38	25
>40%	7	6
Number of newborns enrolled in practice annually
<20	2	49	< .001
20–40	18	33
>40	80	18
Vaccine financing strategy of state in which physician practices^†
VFC only	46	43	> .4
Enhanced VFC	44	45
Universal purchase	10	12

Within each specialty for each characteristic, column percentages sum to 100.
* Includes physicians reporting practice ownership by health maintenance organization.
† Specifically regarding PCV7.

Table 2.

Physicians’ Approaches to Recommending PCV7 for Children Aged 24 to 59 Months

	Percentage of Physicians Who Have Adopted PCV7 in Practice
	For Children Aged 24–59 Months Old Who	Always Recommend PCV7	Sometimes Recommend PCV7	Rarely/Never Recommend PCV7
Have chronic illnesses that affect immunity to infection^*	93	5	2
Have recurrent otitis media^*	51	34	15
Attend daycare^†	44	37	19
Are African American	39	36	26
Are NOT identified as high-risk	27	35	38

* Physician behavior for this high-risk category significantly different from physician behavior for standard-risk 24- to 59-month-olds (bottom row) at p < .001.
† Physician behavior for this high-risk category significantly different from physician behavior for standard-risk 24- to 59-month-olds at p < .01.

Table 3.

Proportion of Family Physicians Who Had Adopted PCV7, by Practice Characteristics

Practice Characteristics	Have Adopted PCV7 (n = 176) (%)	P Value
Number of physicians at practice site
1	54	< .005
2	64
3	55
4	63
5–10	82
>10	81
Proportion of patients <5 years old covered by Medicaid
<10%	57	= .001
10%–40%	73
>40%	85
Proportion of patients who are African-American
<10%	64	< .05
10%–40%	75
>40%	93
Annual newborn enrollment
<20	57	< .001
20–40	71
>40	91

P values indicate level of significance for comparison of proportions of adopters among physicians with different characteristics within each category.

Table 5.

Multivariable Logistic Regression of Family Physician Adoption of PCV7 Recommendations

Model/Variables	Odds Ratio	95% Confidence Interval
Model 1—Practice characteristics^*
Number of newborns annually (>40)^†	3.64	(1.20, 11.01)
Prop. patients on Medicaid (≥0%)^†	2.26	(1.27, 4.04)
Number of physicians (≥4)^†	2.19	(1.21, 3.98)
Prop. patients African American (≥10%)^†	2.13	(1.10, 4.15)
Female physician	1.62	(0.82, 3.22)
Model 2—Clinical experiences & attitudes^‡
Considers giving ≥5 injections at 1 visit^†	17.29	(6.35, 47.05)
Considers giving 4 injections at 1 visit^†	8.69	(4.21, 17.94)
Thinks PCV7 will effectively prevent pneumococcal meningitis	1.86	(0.93, 3.73)
Has experienced severe patient morbidity or mortality from pneumococcal disease	1.45	(0.66, 3.17)
PCV7 approach influenced by rotavirus vaccine	1.09	(0.55, 2.17)
Reports ≥3 problems with multiple injections^†	0.43	(0.22, 0.86)

* Reference group is male family physician with <4 physicians in practice, <10% of patients on Medicaid, <10% African American patients, who enrolls ≤40 newborns annually in her/his panel.
† Statistically significant association with PCV7 adoption.
‡ Reference group is family physician who will consider giving <4 vaccine injections at 1 visit, does not think PCV7 will be effective in preventing pneumococcal meningitis, has not experienced patient morbidity and/or mortality from pneumococcal disease, was not influenced by rotavirus vaccine, and reports <3 problems with multiple injections.