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  • Title: Physician attitudes regarding breakthrough varicella disease and a potential second dose of varicella vaccine.
    Author: Davis MM, Marin M, Cowan AE, Guris D, Clark SJ.
    Journal: Pediatrics; 2007 Feb; 119(2):258-64. PubMed ID: 17272614.
    Abstract:
    OBJECTIVE: We assessed physicians' attitudes about the 1-dose varicella vaccination program and whether physicians think a 2-dose recommendation is needed to reduce the risk of breakthrough disease. METHODS: We conducted a national mail survey of a random sample of 550 pediatricians and 550 family physicians from April to June 2005. Physicians who provide outpatient primary care to children < or = 6 years of age were eligible for analysis. RESULTS: Surveys were returned by 727 respondents, for a response rate of 69%; 610 physicians were eligible. Most respondents (94%) recommend routine 1-dose varicella vaccination, and 79% have seen breakthrough disease in the past 5 years (95% of pediatricians and 58% of family physicians). The majority (68%) agreed or strongly agreed that the current burden of breakthrough disease is acceptable. Only 38% (46% of pediatricians and 28% of family physicians) agreed or strongly agreed that a second dose of varicella vaccine is needed to address the burden of breakthrough disease, whereas 40% were neutral. However, if the Advisory Committee on Immunization Practices were to recommend a second dose of varicella vaccine, then 65% of pediatricians and 39% of family physicians would likely follow the recommendation. Most respondents (78%) would be more willing to recommend a second dose if a combination measles-mumps-rubella-varicella vaccine was available. CONCLUSIONS: Pediatricians and family physicians support the 1-dose varicella vaccination program. A new Advisory Committee on Immunization Practices recommendation for a second dose of varicella vaccine for children was issued after the survey (in June 2006). Two of 3 pediatricians and 2 of 5 family physicians stated that they would adopt a 2-dose recommendation in practice; rates of adoption may be bolstered with current availability of measles-mumps-rubella-varicella vaccine and harmonization of the varicella vaccination schedule with that of measles-mumps-rubella vaccine.
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