THE USE OF VARICELLA VACCINE IN OFFICE BASED PRACTICE: A STUDY FROM PROS AND THE NMA PM Darden, JA Taylor, DA Brooks, AB Bocian. Pediatrics, Medical University of South Carolina, Charleston, SC; Pediatrics, University of Washington, Seattle, WA; Pediatrics, Johns Hopkins University, Baltimore, MD; and Pediatric Research in Office Settings (PROS), Center for Child Health Research, American Academy of Pediatrics, Elk Grove Village, IL. Presented as a poster symposium at the 2000 Pediatric Academic Societies? Annual Meeting.

BACKGROUND: Varicella vaccine (Var) was recommended for routine use by the AAP in all children 12 months and older in May of 1995. Little data are available on its use.

OBJECTIVE: To describe the use of Varicella vaccine in office-based practice.

DESIGN/METHODS: Immunization data were collected from the medical records of up to 120 children 8-35 months of age seen consecutively in the offices of practicing pediatricians. Chickenpox histories were not collected. All practitioners were members of PROS or the National Medical Association. Prior to collecting immunization data, a practitioner from each practice filled out a survey of attitudes and immunization practices. Analysis was restricted to children who were at least 1 year old at the time of the office visit. If the practitioner reported recommending Var to patients, we assumed that the practice started providing the vaccine on the earliest Var date indicated on patient records.

RESULTS: Data were analyzed on 5438 patients from 75 practices in 36 states. Overall, 57% of patients had received Var. Among practices, the percentage of patients receiving Var ranged from 1 to 93%. The policy of referring no vs some patients for immunization was associated with more patients receiving Var (68% Vs 48%, p < 0.01). Almost all, 70 practices, recommended Var. The date that each practice began using Var was between 3/22/96 and 6/12/98 with the median 10/15/96. Eighty percent of practices (56/70), those in the 10th to 90th percentile began using Var over a 13 month period (5/14/96-6/18/97), and the last 10% (7/70) of the practices began using Var over the next 359 days. Receipt of Var did not vary by year of birth: 1995 = 56%, 1996 = 58%, 1997 = 55%. Children up-to-date on other immunizations at 12 months of age were more likely to receive Var (61% Vs 44%, p<0.01). Black and Hispanic children were each more likely to receive Var than white children (65% and 64% Vs 55%, p<0.01 for both comparisons). Higher maternal education was associated with Var receipt (61% college Vs 54% < college, p<0.01).

CONCLUSION: Most practices are recommending Var and 80% began using this vaccine during a 13-month period. Despite increasing availability of Var in pediatric practice, children born in more recent years are not more likely to have received this vaccine. Unlike for many other vaccines, black children are more likely to have received Var than white children.