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Physician and Parent Opinions:  Are Children Becoming Pincushions From Immunizations?

Kathleen A. Woodin, MD; Lance E. Rodewald, MD; Sharon G. Humiston, MD, MPH; Marjorie S. Carges; Stanley J. Schaffer, MD; Peter G. Szilagyi, MD, MPH
Arch Pediatr Adolesc Med. 1995;149(8):845-849. doi:10.1001/archpedi.1995.02170210019003.
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Objective:  To determine parent and physician opinions regarding the administration of multiple childhood immunizations by injection.

Design:  Confidential mailed survey to physicians and residents; interview of parents during office visits for immunizations.

Participants:  Physicians and parents from Rochester, NY.

Results:  The survey included 215 practicing physicians and 74 residents; response rate was 82%. Of the 197 parents interviewed, 93% were mothers, 68% were white; the mean (±SD) age was 25.8±5.2 years, with 12.8±1.8 years of education; 59% had private insurance, and 35% had Medicaid coverage. Of the parents, 31% had strong concerns about their child receiving a single injection; an additional 10% (total, 41% vs 31%; X2=4.05, P=.04) had the same concerns about their child receiving three injections. More practicing physicians than parents had strong concerns about children 7 months old or younger receiving three injections (60% vs 41%; X2=7.71, P≤.01). Physician concern increased further when physicians were asked about administration of four injections (80% vs 60%; X2=18.77, P<.001). Of the parents, 64% preferred one rather than two visits to have three injections administered, if their physician recommended it; 58% still preferred one visit even if four injections were needed.

Conclusions:  Physicians have more concerns than parents about the administration of multiple injections at a single visit. Pain for the child was the main concern of all respondents. While most physicians have strong concerns about administering three or more injections at one visit, most parents prefer this practice. Continued education and reassurance of parents and physicians is needed to address concerns about children becoming "pincushions" from immunizations.(Arch Pediatr Adolesc Med. 1995;149:845-849)

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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