Vaccine Attitudes and Practices Among Family Medicine (FM) Providers Across New York State Following Changes in ACIP Vaccine Recommendations

Background: Provider vaccine hesitancy represents a potential barrier to vaccinations. We describe FM provider vaccine beliefs and behaviors.

Methods: FM providers from NYS completed an anonymous self-administered survey regarding vaccine attitudes and practices between January and March 2016.

Results: 177 surveys were completed by physicians (70%) and mid-level providers (30%). 160 providers always recommend standard pediatric vaccines, yet only 79% of this group always recommend HPV vaccine to eligible 11-12 year olds. 73% of providers strongly disagreed that administering HPV vaccine to adolescents increases the likelihood of unprotected sex. Fewer than 75% strongly disagreed that multiple vaccines administered at a visit reduced vaccine efficacy or overwhelms the immune system. Only 83% of providers strongly disagreed that autism is a possible effect of vaccines. Mid-level providers were more likely than physicians to have higher mean levels of agreement that autism is a possible effect of vaccines (p=0.02), multiple vaccines administered at a visit reduces efficacy or overwhelms the immune system (p < 0.001), and administering HPV vaccine to adolescents increases the likelihood of unprotected sex (p=0.001). Providers in practice for <10 years were more likely than those in practice longer to have higher mean levels of agreement that multiple vaccines administered at a visit reduces efficacy or overwhelms the immune system (p =0.01), and administering HPV vaccine to adolescents increases the likelihood of unprotected sex (p=0.04). The 177 providers were still more likely to recommend HPV vaccine to eligible patients aged 13-18 years (88%) than 11-12 years (75%) or 19-26 years (70%). Only 73% of providers immunized pregnant women in the office. These providers were more likely to recommend influenza vaccine (p=0.01) to their pregnant patients. 3% of providers stated they were vaccine hesitant, yet 32% do not always recommend standard pediatric, influenza, pertussis, HPV, pneumococcal, or zoster vaccines to eligible patients for whom a category A ACIP recommendation exists.

Conclusion: Vaccine hesitancy is under-recognized among FM providers. Vaccine misperceptions continue to be noted, revealing the need for ongoing provider education.