PEDIATRICIAN?S? PRACTICES REGARDING COMMUNICATING AND DOCUMENTING VACCINE RISK/BENEFIT INFORMATION Karen G. O'Connor, Geoffrey Evans Division of Health Policy Research, American Academy of Pediatrics, Elk Grove Village, IL; National Vaccine Injury Compensation Program, Rockville, MD

BACKGROUND: Communicating vaccine safety information and ensuring informed consent are important goals in patient care. Vaccine Information Statements (VIS) facilitate communication with parents regarding immunization risks/benefits.

OBJECTIVE: Assess current practices regarding risk/benefit communication, distribution and documentation of VIS, and documentation of informed consent.

DESIGN/METHODS: National random sample, mailed Periodic Survey of American Academy of Pediatrics (AAP) members between February and May 2001. Response rate=64%; n=815 pediatricians who offer immunizations for which VIS are available.

RESULTS: More than half of pediatricians verbally discuss vaccine risks/benefits, distribute VIS, document provision of VIS in the patient's record, and obtain parent's signature as evidence of consent with every dose of each vaccine; few regularly document verbal consent. (Nearly all pediatricians use VIS at some point during the vaccine series; data not shown.) These practices are similar across vaccines.

Practices vary by pediatricians' characteristics, eg, pediatricians who distribute VIS with every dose are more likely to be <age 43 (64.3% v 56.4%, p<.05) and practice in the Midwest or South (72.2% MW v 67.7% S v 54.3% W v 48.9% NE, p<.001).

CONCLUSIONS: While a majority of pediatricians discuss, distribute and document provision of VIS, as well as obtain signed consent, each time a vaccine is administered, a large proportion do not. Vaccine administration practices vary by physician and practice characteristics. Ongoing efforts are needed to ensure vaccine risk/benefit communication.