Article/study on what physicians vaccinate their kids for and their concerns

[kathymuggle]

I found this and thought is was interesting.  It is a study on vaccine practices among physicians.  It does break it down by vaccine somewhat, so you can see what vaccines they find the most and least merit in.  Do read the whole study (or at least skim thoroughly) this is one study where a  lot of the good stuff is embedded in the text and not the tables.

Enjoy!

www.scirp.org/journal/PaperDownload.aspx?paperID=22932

[japonica]

Granted it's a very small study and has a number of limitations etc., but I found it interesting that 20% of respondents who are generalists and 33% of the subspecialists have withheld vaccines from their own kids based on "safety concerns." Yet if many of us bring up these same safety concerns with our HCPs, we get the "how to talk parents around into vaccinating" spiel. Hmm.

[Dakotacakes]

Originally Posted by japonica 

Granted it's a very small study and has a number of limitations etc., but I found it interesting that 20% of respondents who are generalists and 33% of the subspecialists have withheld vaccines from their own kids based on "safety concerns." Yet if many of us bring up these same safety concerns with our HCPs, we get the "how to talk parents around into vaccinating" spiel. Hmm.

That isn't what the study found though. Of the 336 generalists in the study 95% vaccinate on schedule and of the 128 specialists 92% vaccinate on schedule. Only 5% of generalists and 8% of specialists had delayed or withheld a vaccine at all. OF THOSE that withheld or delayed vaccines 20% of the generalists of withheld vaccines did so for safety concerns and 33% of subspecialists who have withheld or delayed vaccines did so for safety concerns.

Actually a total of 3 of the 336 generalists withheld or delayed a vaccine for their own child for safety concerns so less than 1% of the sample (.8%) and of the 128 subspecialists also 3 had withheld or delayed a vaccine for safety reason , roughly 2%.

This study found that the vast majority of pediatricians vaccinate on schedule, and a vast majority plan to vaccinate future progeny on schedule as well. I did find it interesting that doctors who went to med schoo before 1990 are less likely to vaccinate for Rota. My guess is it is because when they went to med school that vaccine didn't exist.

[prosciencemum]

Fascinating. Thanks for the corrections on the statistics dakotacakes.

[kathymuggle]

The discussion on what they would do if they had to make the decision now or in the future interested me:

"What is observed from this study is the intent of some general pediatricians (5%) and a higher proportion of specialists (19%) to delay the MMR vaccination beyond 18 months of age despite recent increases in incidence of Measles disease….

A significant number of subspecialists did not want to give hepatitis A (6%), rotavirus (12%), and meningo- coccal vaccine (9%) moving forward."

I think it is a given most doctors want to vaccinate.  This is where all their training points. What I think is interesting is knowing which vaccines give even doctors pause.

Edited by kathymuggle - 1/9/13 at 4:48pm

[japonica]

Originally Posted by Dakotacakes 


That isn't what the study found though. Of the 336 generalists in the study 95% vaccinate on schedule and of the 128 specialists 92% vaccinate on schedule. Only 5% of generalists and 8% of specialists had delayed or withheld a vaccine at all. OF THOSE that withheld or delayed vaccines 20% of the generalists of withheld vaccines did so for safety concerns and 33% of subspecialists who have withheld or delayed vaccines did so for safety concerns.

Actually a total of 3 of the 336 generalists withheld or delayed a vaccine for their own child for safety concerns so less than 1% of the sample (.8%) and of the 128 subspecialists also 3 had withheld or delayed a vaccine for safety reason , roughly 2%.

This study found that the vast majority of pediatricians vaccinate on schedule, and a vast majority plan to vaccinate future progeny on schedule as well. I did find it interesting that doctors who went to med schoo before 1990 are less likely to vaccinate for Rota. My guess is it is because when they went to med school that vaccine didn't exist.

Thanks for the clarification. That's what you get when you skim, not actually read. Darn real life getting in the way of my internet time!

I agree about the rota. Talking to older doctors (our GP and our former peds, all in their 50s and 60s), none of them heartily recommended it.

[Rrrrrachel]

I know this is kind of old news, but is delaying MMR past 18 months because of safety, or because some evidence shows it's more effective after 18 months than 12 months?  Just because a doctor is choosing to forego or delay a vaccine doesn't automatically mean it's because they think it's risky.

Also, like people, some doctors are more informed than others.  I'm not going back to the drawing board on my vaccine research just because a limited number of doctors, who may or may not have expertise in applicable fields and whose credentials I don't know, have concerns.  Not when the actual experts on vaccines have spoken so consistently and thoroughly in favor of their safety and efficacy.

[kathymuggle]

Originally Posted by Rrrrrachel 

I know this is kind of old news, but is delaying MMR past 18 months because of safety, or because some evidence shows it's more effective after 18 months than 12 months?  Just because a doctor is choosing to forego or delay a vaccine doesn't automatically mean it's because they think it's risky.

The concern seems to be around safety issues:

"Of the respondents who would elect to withhold at least one vaccine for future

progeny (63 of 70 who actually reported having children), the most common reason given was “safety” and “too many vaccines given at once”

and….

"what is observed from this study is the intent of some general pediatricians (5%) and a higher proportion of specialists (19%) to delay the MMR vaccination beyond 18 months of age despite recent increases in incidence of Measles disease [18]. This is somewhat unexpected given the time and resources spent to discredit any asso- ciation between MMR and autism, but it does mimic the public trend. One physician even goes so far to comment that there is “no need to introduce another potentially confounding variable (MMR vaccine) until development is clearly normal.”

Also, like people, some doctors are more informed than others.  I'm not going back to the drawing board on my vaccine research just because a limited number of doctors, who may or may not have expertise in applicable fields and whose credentials I don't know, have concerns.

Absolutely.  I am not going back to the drawing board because most doctors do vaccinate (although 19% of medical specialist delaying MMR is higher than the rate of the general public).  I have always been of the belief that the parent shouId research the vaccines and VADs and make the decision.  

I am not sure if you are part of the "listen to your doctor, trust your doctor, they are the experts" pro-vax brigade or not.  If you are, the above seems a bit of an odd statement.  Listen to your doctor if he or she supports your research, but not if they don't?

Edited by kathymuggle - 1/16/13 at 6:28am

[Rrrrrachel]

I am of the find a doctor you trust and listen to their advice brigade. Not trust the advice of some random doctor without knowig anything about them brigade.

[Rrrrrachel]

And like I said about mmr, I'm thinkin that decision is more about it being slightly more effective than safety.

[Turquesa]

http://www.ama-assn.org/amednews/2011/11/07/hlsa1107.htm

On this same topic, this article is interesting.

[sonjagrabel]

Interesting. Thanks for sharing. It is a very small study and the participation was pretty low - I wonder what the docs who didn't participate think. . . Were they just too busy or did they realize the purpose of this study and intentionally avoid it??? (It is pretty clear that the authors are looking for trends of who doesn't vaccinate to try to "educate" those groups so they will follow the schedule. I like how they assume that specialists who skip vaccines do so bc they don't know enough about the vaccines and diseases, and don't consider that it may be bc they are the ones dealing with the vaccine side effects and see the risks.