Understanding physician agreement with varicella immunization guidelines.

Background: Although varicella vaccine was licensed in 1995, immunization rates are only moderate. This study identifies factors associated with physician self-reported likelihood of recommending varicella vaccination to patients.

Methods: Two hundred eighty-one Minnesota and Pennsylvania primary care physicians who participated in surveys on barriers to vaccination in 1990-1991 and 1993 were surveyed in 1999, assessing physicians' beliefs about varicella disease and vaccine and their self-reported likelihood of recommending varicella vaccine to three age groups of children.

Results: Most (79, 80, and 83%) were likely to recommend varicella vaccine for 12- to 18-month old, 4- to 6-year-old, and 11- to 12-year old children, respectively, and most (78%) agreed with national recommendations to vaccinate. If physicians believed that the vaccine would fail, they were less likely to recommend varicella vaccination for 12- to 18-month-old (70% vs 85%, P = 0.001) and 4- to 6-year-old (83% vs 85%, P = 0.001) children, than if they believed in its efficacy. Pediatricians were more likely to recommend varicella vaccine than were family physicians and general practitioners (P < 0.01).

Conclusions: Physicians, especially pediatricians, report that they recommend varicella vaccination when they agree with national recommendations, believe in the efficacy of the vaccine, and perceive that parents want the vaccine for their children.