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Research ArticleOriginal Article

Knowledge And Attitudes Of Minnesota Primary Care Physicians About Barriers To Measles And Pertussis Immunization

Richard Kent Zimmerman, G. Scott Giebink, Heidi Bosch Street and Janine E. Janosky
The Journal of the American Board of Family Practice July 1995, 8 (4) 270-277; DOI: https://doi.org/10.3122/jabfm.8.4.270
Richard Kent Zimmerman
From the Department of Family Medicine and Clinical Epidemiology, School of Medicine, University of Pittsburgh (RKZ, JEJ); Departments of Pediatrics and Otolaryngology, University of Minnesota School of Medicine, Minneapolis (GSG); and Department of Family Practice and Community Health, University of Minnesota, Minneapolis (HBS). Part of this work was done while Dr. Zimmerman was a fellow in the Department of Family Practice and Community Health and a resident in General Preventive Medicine and Public Health at the University of Minnesota. Address reprint requests to “Reprints,” Richard Zimmerman, MD, Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, M-200 Scaife Hall, Pittsburgh, PA 15261
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G. Scott Giebink
From the Department of Family Medicine and Clinical Epidemiology, School of Medicine, University of Pittsburgh (RKZ, JEJ); Departments of Pediatrics and Otolaryngology, University of Minnesota School of Medicine, Minneapolis (GSG); and Department of Family Practice and Community Health, University of Minnesota, Minneapolis (HBS). Part of this work was done while Dr. Zimmerman was a fellow in the Department of Family Practice and Community Health and a resident in General Preventive Medicine and Public Health at the University of Minnesota. Address reprint requests to “Reprints,” Richard Zimmerman, MD, Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, M-200 Scaife Hall, Pittsburgh, PA 15261
MD
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Heidi Bosch Street
From the Department of Family Medicine and Clinical Epidemiology, School of Medicine, University of Pittsburgh (RKZ, JEJ); Departments of Pediatrics and Otolaryngology, University of Minnesota School of Medicine, Minneapolis (GSG); and Department of Family Practice and Community Health, University of Minnesota, Minneapolis (HBS). Part of this work was done while Dr. Zimmerman was a fellow in the Department of Family Practice and Community Health and a resident in General Preventive Medicine and Public Health at the University of Minnesota. Address reprint requests to “Reprints,” Richard Zimmerman, MD, Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, M-200 Scaife Hall, Pittsburgh, PA 15261
MD
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Janine E. Janosky
From the Department of Family Medicine and Clinical Epidemiology, School of Medicine, University of Pittsburgh (RKZ, JEJ); Departments of Pediatrics and Otolaryngology, University of Minnesota School of Medicine, Minneapolis (GSG); and Department of Family Practice and Community Health, University of Minnesota, Minneapolis (HBS). Part of this work was done while Dr. Zimmerman was a fellow in the Department of Family Practice and Community Health and a resident in General Preventive Medicine and Public Health at the University of Minnesota. Address reprint requests to “Reprints,” Richard Zimmerman, MD, Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, M-200 Scaife Hall, Pittsburgh, PA 15261
PhD
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Abstract

Background: Understanding the causes of low levels of childhood immunization is critical to preventing outbreaks of vaccine-preventable diseases. Hence, we examined physicians' knowledge and attitudes about measles and pertussis vaccines and barriers to immunization.

Methods: We developed a telephone questionnaire, subjected it to a pilot test, and subsequently interviewed Minnesota pediatricians, general practitioners, rural family physicians, and urban family physicians. The physicians were selected by a random process.

Results: The response rate was 76.4 percent (411 of 538 eligible physicians). Almost all physicians thought that vaccine efficacy was high and that the likelihood of serious side effects was low. Respondents were divided, however, about the likelihood of serious complications from pertussis disease and the role of adults as a pertussis reservoir. Many physicians inappropriately believed certain conditions were contraindications to vaccination; for instance, 33 percent of physicians would not administer measles, mumps, and rubella vaccine to a child whose mother was pregnant. Many physicians (31 percent) would not administer four vaccines simultaneously because of concerns that included parental acceptance and vaccine efficacy. Physicians were more likely to refer children without insurance (P<0.00l) or with Medicaid (P<0.001) than children with insurance to health department vaccine clinics for immunization.

Conclusions: For immunization rates to reach high levels, changes are needed in health care system issues, such as vaccine reimbursement, and in provider practices, such as interpretation of vaccine contraindications.

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The Journal of the American Board of Family     Practice: 8 (4)
The Journal of the American Board of Family Practice
Vol. 8, Issue 4
1 Jul 1995
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Knowledge And Attitudes Of Minnesota Primary Care Physicians About Barriers To Measles And Pertussis Immunization
Richard Kent Zimmerman, G. Scott Giebink, Heidi Bosch Street, Janine E. Janosky
The Journal of the American Board of Family Practice Jul 1995, 8 (4) 270-277; DOI: 10.3122/jabfm.8.4.270

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Knowledge And Attitudes Of Minnesota Primary Care Physicians About Barriers To Measles And Pertussis Immunization
Richard Kent Zimmerman, G. Scott Giebink, Heidi Bosch Street, Janine E. Janosky
The Journal of the American Board of Family Practice Jul 1995, 8 (4) 270-277; DOI: 10.3122/jabfm.8.4.270
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