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| PERIODIC
SURVEY OF FELLOWS
American Academy of Pediatrics Division of Health Policy Research ABSTRACT Presented at the Pediatric
Academic Societies annual meeting, May 2002 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. |
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