RT Journal
A1 Gidengil CA, Dutta-Linn M, Messonnier ML, Rusinak D, Lieu TA
T1 FInancial barriers to the adoption of combination vaccines by pediatricians
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2010
FD December 1
VO 164
IS 12
SP 1138
OP 1143
DO 10.1001/archpediatrics.2010.222
UL http://dx.doi.org/10.1001/archpediatrics.2010.222
AB Objectives 
    To describe the prevalence of combination vaccine use and the associated financial barriers faced by pediatric practices, and to identify determinants of adoption of combination vaccines.Design 
    Mailed national survey.Setting 
    Pediatric practices during the period from August through October 2008.Participants 
    Pediatricians randomly selected from the American Medical Association Masterfile.Main Outcome Measure 
    Use of 1 of 2 infant combination vaccines (the diphtheria and tetanus toxoids and acellular pertussis, hepatitis B virus, and inactivated poliovirus [DTaP-HepB-IPV] vaccine or the DTaP, IPV, and Haemophilus influenzae type b [DTaP-IPV/Hib] vaccine).Results 
    We received 629 responses (response rate, 67%). Four hundred ninety-two pediatricians (78%) reported using 1 or both of the infant combination vaccines of interest (ie, the DTaP-HepB-IPV or DTaP-IPV/Hib vaccine). More than half of the respondents said their practice did not receive adequate reimbursement for the purchase and administration of vaccines in general. More than one-fifth reported not using 1 or more of the combination vaccines because of inadequate reimbursement for the cost of vaccine doses (23% of respondents) and/or vaccine administration (20% of respondents). The infant combination vaccines studied were less likely to be used by smaller practices, by those with a lower proportion of publicly insured patients, and by those with less inclusive state vaccine financing policies.Conclusions 
    One in 5 pediatricians reported that inadequate reimbursement prevented their using 1 or more combination vaccines. Practice size as well as the proportion of children whose vaccinations are paid for by public funds appear to be important determinants of the adoption of combination vaccines.