摘要

OBJECTIVE: To examine the awareness, knowledge, barriers to usage and acceptance of recommended adult vaccines among obstetrician/gynecologists (OB/GYNs) compared to other adult primary care providers (APCPs).
STUDY DESIGN: A self-administered survey was sent to 1,000 OB/GYN, 1,000 family practice and 1,000 internal medicine physicians nationwide.
RESULTS: Of 3,000 mailed surveys, 733 (24.8%) were returned. Of those, 617 (84.18%) reported providing primary care to adults. Only 53.04% of APCPs reported having a vaccine record on >50% of their primary care patients, with 33.15% of OB/GYNs having no record. This absence of a record was significantly greater for OB/GYNs vs. other APCPs. OB/GYNs were also significantly less likely to routinely discuss the importance of vaccines and offer any vaccines. With the exception of HPV vaccine, other providers were significantly more likely to provide Td, Tdap, influenza, hepatitis B and MMR compared to OB/GYNs. Overall 58.24% of APCPs administered vaccines to pregnant women: 4.86% administered MMR and 2.86% administered HPV vaccine, vaccines not recommended during pregnancy. Poor reimbursement and lack of knowledge and training in vaccine use were major factors that prevented APCPs from offering vaccines. The greatest perceived barriers to patient vaccine acceptance included concern about adverse effects, perceived lack of disease risk, distrust of vaccines, lack of disease awareness and cost.
CONCLUSION: Intensive programs aimed at familiarizing APCPs with vaccine-preventable diseases and the importance of using vaccines are needed in order to improve vaccination rates. (J Reprod Med 2011;56:301-307)