Findings from Recent Consumer and Health-Care Provider Surveys Adelphi Research by Design
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Transcript of Findings from Recent Consumer and Health-Care Provider Surveys Adelphi Research by Design
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Findings from Recent Consumer and Health-Care Provider Surveys
Adelphi Research by Design
supported by sanofi pasteur
David R. Johnson, MD, MPH NVAC MeetingDirector, Scientific & Medical Affairs October 22, 2007sanofi pasteur Washington DC
Barriers to Adult Immunization
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Objectives, Focus, MethodologiesUndertaken to provide assessment of reasons US adults do not get recommended vaccines & to inform efforts to increase rates
Focus on influenza, pneumococcal & Td vaccines
Structured telephone interviews during Sept & Oct 2006
2002 consumersConsumers selected using Random Digit Dialing samplingData weighted to approximate US population characteristics
200 health-care providers (HCP)100 primary care physicians33 physician assistants, 33 nurse practitioners, and 34 registered nursesRecruited through a national database
Sampling errorTotal consumer sample: ±2.2% [95% CI]Health-care provider sample: ±9.8% [95% CI]
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Key Finding: Provider Recommendations Are a Critical Factor in Consumer Decisions
80% of consumers are likely to follow a health-care provider’s recommendation to get a vaccine; unfortunately, most consumers never talk to their HCP about vaccines
Percent who are aware of the vaccine, but have never talked to their HCP about:
Pneumococcal vaccine by target population:≥65 years of age (56%)Chronic illness or condition (45%)
Tetanus vaccine (69%)Influenza vaccine (61%)
Among the listed reasons consumers do not get vaccinations, “My doctor has not told me I need it” is cited often:
Pneumococcal (53%)Tetanus (51%)Influenza (39%)
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Key Finding: HCPs and Consumers Have Different Perspectives on Why People Forego Vaccination
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Influenza Pneumococcal Tetanus
Percent Citing Side Effects
1316
4
64
38 37
Consumers
Health-care Providers
Vaccine
Consumers: What are the main reasons you might not get a (vaccine name) as recommended?
HCPs: What are the main reasons that might prevent the adult patients in your practice from getting each vaccine as recommended?
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Reasons Consumers Forego Vaccination: Tetanus, Aided Responses*
0 10 20 30 40 50 60 70 80
Costs too much
Insurance does not cover
Dislike needles
May have side effects
Do not visit doctor regularly
Do not know when to get it
Doctor has not told me I need it
Healthy, do not need it
Only need it when injured
Yes, that is a reason (%)
*Would you say [REASON] is a reason you have not received a tetanus vaccine as recommended?
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Key Finding: Consumers Lack Awareness About Adult Vaccines
At best, fewer than half of consumers believe they will need a particular vaccine in the future:
Influenza (46%)Pneumococcal (19%)30% do not know or do not believe they will need any vaccinations in the future
Consumers are unaware of vaccine recommendationsWhich adults need an influenza vaccine?
Seniors, elderly, and adults ≥65years of age (44%)All adults (31%)Adults ≥50 years of age (7%)
51% do not believe all adults need a tetanus vaccination
Substantial numbers of consumers do not believe they are at risk of getting ill if they are not vaccinated
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Key Finding: There Are Gaps in HCP Knowledge and Practices
Immunization schedules are issued annually by the CDC*, based on input and guidance from a 15-member expert panel (ACIP†)
40-44% of HCPs do not make use of these resources
Mild to moderate illnesses, even with fever, do not contraindicate vaccination
26-30% believe sick patients should not be vaccinated, regardless of severity of illness
All adults ≥50 years of age should get an influenza vaccine annually
72% MDs, 85% NP, PA, and RN do not correctly identify people in this age group as recommended for annual vaccination
A tetanus booster is recommended every 10 years for adults19% MD, 21% NP, PA, and RN are not aware of or do not believe a booster is necessary every 10 years
*CDC=Centers for Disease Control and Prevention;†ACIP=Advisory Committee for Immunization Practices
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Key Finding: Lack of Regular Well-care Visits is a Barrier to Vaccination
24% of consumers have not had a well-care visit >12 months;
likelihood varies by gender, age, health:Men (33%) vs. women (17%)
Age: 19-34 years (30%) and 35-44 years (32%) versus ≥65 years (11%)
Excellent or very good health (27%) versus good, fair, or poor health (21%)
Well-care Visit (%) Acute-care Visit (%)
MD 73 29
PA, NP, and RN 77 42
Likelihood of HCPs Discussing & Recommending Vaccines by Visit Type*
*HCP self-report
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Key Finding: Cost Is Not a Major Barrier to Adult Immunization
Vaccine Unaided* (ranking) Aided† (ranking)
Influenza 7% (5) 18% (10)
Pneumococcal 3% (6) 14% (11)
Tetanus 7% (6) 17% (9)
Consumers Citing Cost as a Barrier, by Vaccine
*What are the main reasons you might not get a(n) influenza, pneumococcal, or tetanus vaccine?
†Would you say (cost) is a reason you have not received a(n) influenza, pneumococcal, or tetanus vaccine?
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Consumer Sub-population Differences by Insurance Status
Consumers citing cost as a barrier to vaccination
Unaided (%) Aided (%)
Insured Uninsured Insured Uninsured
Tetanus 4 17 10 38
Influenza 3 18 13 34
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Summary: Survey Indicates Main Consumer Barriers Relate to Knowledge
Major barriers includeLack of health-care provider recommendations
Lack of consumer, and even health-care provider, knowledge about vaccines
Absence of well-care visits for many consumers
Cost appears to be a less important barrier,
even among those most sensitive to itVariations in cost sensitivity seen among those with lower incomes and no insurance
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Strategies to Increase Immunization Rates
Increase awareness Large percentage of consumers, and even health-care providers, are unaware of immunization schedules and recommendations
Increase knowledgeVaccines are safe and effective
Vaccine-preventable diseases (VPD) are serious
Encourage health-care providers to routinize adult
immunizationHealth-care provider recommendations will have a strong, positive effect on patient vaccination decisions
Health-care providers are best situated to dispel consumer fears and misconceptions about vaccines and VPDs
Expand first-dollar insurance coverageSupport increased private sector vaccination coverage as part of routine care