Variation in Immunization Practices

Principal Investigator: Gary Freed, MD, MPH, UM SPH
Project Dates: 2004 – 2009
Funding: Centers for Disease Control and Prevention

Description:

Immunizations have been the major contributor to the reduction in infectious disease morbidity and mortality over the past century. However, not everyone who could benefit from vaccines receives immunizations on schedule, for reasons such as lack of awareness of immunization recommendations, missed opportunities for vaccination, increased complexity of the immunization schedule, concern about vaccine safety, cost of immunization services, and disruptions in vaccine supply.

To aid the CDC’s National Immunization Program in its efforts to achieve immunization goals for the nation, timely information regarding the attitudes and practices of health care providers, payers, public health officials, and parents/patients is essential. Such information allows the CDC to monitor recent and ongoing situations, and to plan and create effective programs tailored to these constituencies.

Variation in Immunization Practices (VIP) is a collaborative project between the CDC’s National Immunization Program and the University of Michigan’s Child Health Evaluation and Research (CHEAR) Unit. The VIP project team conducts four studies per year in accordance with the specific needs of the CDC’s National Immunization Program. Using both qualitative and quantitative methods, the VIP research team conducts studies in a time frame to allow the results to be directly applicable to current and future CDC efforts in child and adult immunization. Sudies focus on agreement and adoption of new immunization recommendations; issues related to vaccine supply; insurance coverage for childhood and adult vaccines; and the impact of changes in vaccine financing on physician and patient behavior; and provider and patient assessment of CDC educational materials. Study findings are presented as written reports to CDC officials, with additional presentation of findings to workgroups or other agencies as desired by the project’s CDC technical advisors.

Publications:

Clark, S. J., Cowan, A. E., & Wortley, P. M. (2009). Influenza vaccination attitudes and practices among US registered nurses. American Journal of Infection Control, 37(7), 551-556.

Clark, S. J., Cowan, A. E., Wortley, P. M. (2009). Worksite policies related to influenza vaccination: A cross-sectional survey of US registered nurses. Human Vaccines, 5(8), 545-550.

Dempsey, A. F., Cowan, A. E., Broder, K. R., Kretsinger, K., Stokley, S., & Clark, S. J. (2009). Adolescent Tdap vaccine utilization among primary care physicians. Journal of Adolescent Health, 44(4), 387-393.

Dempsey, A. F., Cowan, A. E., Broder, K. R., Kretsinger, K., Stokley, S., & Clark, S. J. (2009). Diagnosis and testing practices for adolescent pertussis among a national sample of primary care physicians. Preventative Medicine, 48(5), 500-504.

Dempsey, A. F., Cowan, A. E., Stokley, S., Messonier, M., Clark, S. J., & Davis, M. M. (2008). The role of economic information in decision-making by the Advisory Committee on Immunization Practices. Vaccine, 26(42), 5389-5392.

Freed, G. L., Cowan, A. E., & Clark, S. J. (2008). Primary care physician perspectives on reimbursement for childhood immunizations. Pediatrics, 124(Suppl 5), S466-S471.

Freed, G. L., Cowan, A. E., Gregory, S., & Clark, S. J. (2008). Variation in provider vaccine purchase prices and payer reimbursement. Pediatrics, 124(Suppl 5), S459-S465.

Davis, M. M., Cowan, A. E., Marin, M., Guris, D., & Clark, S. J. (2007). Physician attitudes regarding breakthrough varicella disease and a potential second dose of varicella vaccine. Pediatrics, 119(2), 258-264.

Clark, S. J., Adolphe, S., Davis, M. M., Cowan, A. E., & Kretsinger, K. (2006). Attitudes of US obstetricians toward a combined tetanus-diphtheria-acellular pertussis vaccine for adults. Infectious Diseases in Obstetrics and Gynecology, 1-5.

Clark, S. J., Cowan, A. E., Stokley, S., Bilukha, O., & Davis, M. M. (2006). Physician perspectives to inform a new recommendation for meningococcal conjugate vaccine (MCV4). Journal of Adolescent Health, 39(6), 850-855.

Davis, M. M., Broder, K., Cowan, A. E., Mijalski, C., Kretsinger, K., Stokley, S., & Clark, S. J. (2006). Physician attitudes and preferences about combined Tdap vaccines for adolescents. American Journal of Preventative Medicine, 31(2), 176-180.

Selected Presentations:

Private-sector cost and reimbursement for vaccines: financial impact of combination vaccines. (2009, May). Presentation at the Pediatric Academic Societies Annual Meeting, Baltimore, MD.

Physician adoption of ACIP recommendations for vaccinating adolescents against pertussis using Tdap. (2008, March). Presentation at the National Immunization Conference, Atlanta, GA.

Physician adoption of ACIP recommendations for vaccinating adolescents against pertussis using Tdap. (2008, May). Presentation at the Pediatric Academic Societies Meeting, Honolulu, HI.

Physician attitudes toward vaccine reimbursement: A national survey. (2008, March). Presentation at the National Immunization Conference, Atlanta, GA.

Private-sector cost and reimbursement for childhood vaccines. (2008, March). Presentation at the National Immunization Conference, Atlanta, GA.

Nurses’ knowledge, attitudes, and practices related to influenza vaccination. (2007, March). Presentation at the National Immunization Conference, Kansas City, MO.

Preferences for the childhood immunization schedule: Results of focus groups with immunization providers. (2006, October). Presentation for the US Advisory Committee on Immunization Practices, Atlanta, GA.