Late-season influenza vaccination: a national survey of physician practice and barriers.

Background: Although late-season influenza vaccination has been recently promoted, existing data suggest it occurs infrequently.

Purpose: This study aims to describe among primary care physicians: (1) late-season vaccination practices; (2) perceived barriers; and (3) factors associated with late-season influenza vaccination in a year when vaccine supplies are inadequate or delayed.

Methods: A survey administered March 2007-June 2007 to 1268 primary care providers in a national survey network. Data analysis was completed in 2009.

Results: Overall response rate was 74% (n=940). Seventy-one percent of respondents reported vaccinating until February/March when there were adequate vaccine supplies and 84% reported vaccinating until February/March when vaccine supplies were inadequate or delayed. Perceived barriers to late-season vaccination included difficulty administering a second dose in children if the first was given late in the season (91% of respondents); providers/patients forgetting about vaccination (77%); and concern about having unused vaccine left at the end of a season (74%). Physicians who reported vaccinating into February/March when vaccine supplies were inadequate or delayed more often reported believing late-season vaccination is clinically beneficial, experiencing difficulty persuading patients to accept late-season vaccination, forgetting about the need for vaccination, not being able to meet demand for influenza vaccine and experiencing high patient volumes during winter months.

Conclusions: Most physicians appear willing to perform late-season vaccination despite existing data demonstrating that it occurs infrequently. Efforts to increase late-season vaccination should address vaccine supply issues, late-season influenza vaccine reminders, and patient and provider education on its clinical benefits.