Although early childhood hepatitis B vaccination rates have risen dramatically in the United States, there are still areas with low rates. Understanding the barriers to vaccination as perceived by primary care physicians is key to raising rates in such areas.METHODS.
A stratified random sample of family physicians, pediatricians, and general practitioners-younger than age 65 and having office-based practices across the United States-was selected from the American Medical Association physician list, including nonmembers. A standardized telephone survey was conducted by trained interviewers in 1995. Physicians seeing 5 or more patients younger than age 6 per week and having a practice comprising ≥50% primary care patients were eligible.RESULTS.
Most physicians (78%) rated the importance of hepatitis B vaccine as high. Based on regression analyses, the primary determinants of the importance of hepatitis B vaccine were: no stated concerns about its routine use (odds ratio [OR] = 2.8; 95% confidence interval [CI], 1.7 - 4.7), low disease incidence/importance in the practice (OR = .33; 95% CI, .18 - .60), preference for administering hepatitis B vaccine during adolescence (OR = .36; 95% CI, .18 - .72), specialty as family physician (OR = .36; 95% CI, .23 - .57), and specialty as general practitioner (OR = .37; 95% CI, .21 - .63).CONCLUSIONS.
Most primary care physicians recommend hepatitis B vaccination, although a number of concerns exist. Given that only 4 years had elapsed from the time of the new recommendations for routine early childhood hepatitis B vaccination in 1991 until this survey, remarkable progress has been made.