Pain, Price, Insurance Delays Associated With Vaccines Worry Doctors.(Brief Article)

2001 DEC 12 - (NewsRx.com & NewsRx.net) -- When a new vaccine to protect infants and children against meningitis, pneumonia and ear infections was introduced last year, the public's response was overwhelming: parents clamored to get their children vaccinated, as advertising and media coverage touted the shot's effectiveness.

Within months, supplies of the vaccine had become scarce. But some doctors who care for children - including those who recommend the pneumococcal conjugate vaccine, known as Prevnar - are expressing concerns that the vaccine is too expensive, adds yet another injection to infants' already vaccine-heavy office visits, and initially wasn't covered by many public and private insurers, creating an unequal situation for some kids.

The doctors were interviewed by University of Michigan Health System researchers as part of a pilot survey of two dozen physicians in seven states conducted for the U.S. Centers for Disease Control and Prevention and published in the November 2001 of Ambulatory Pediatrics. The study points out issues that may have significance for the introduction of future vaccines now in the pipeline, says lead author Matthew Davis, MD, MAPP. Davis, a lecturer in pediatrics and internal medicine, and member of the UMHS Child Health Evaluation and Research (CHEAR) Unit, conducted the survey with U-M colleagues to provide early data to the CDC within months of Prevnar's introduction, and to pave the way for a larger national survey of more than 1000 physicians, the results of which are still being analyzed.

"Doctors have been caught in the middle with this vaccine's introduction, and even those who are recommending it to their patients' parents express strong reservations about the financial and social issues it has raised," says Davis. "As we look toward the future of vaccination, it appears that primary care physicians want more combination vaccines, lower vaccine costs, and less delay in availability of vaccines for disadvantaged children. Without these, we may see lower childhood vaccination rates, even for new and effective immunizations."

Three quarters of the pediatricians and family doctors contacted for the survey said they were recommending Prevnar for their youngest patients, as endorsed by the CDC and the American Academy of Pediatrics in June, 2000. But the rest were not. The biggest factor causing some to refrain from recommending it, and others to have reservations about doing so, was cost. Pediatricians and family practitioners often take a financial risk in buying a supply of perishable vaccine, not knowing if they will use it all.

Prevnar's high cost - nearly $260 for four doses - made it an especially risky proposition for doctors, and even more so for those in solo practice. Those parents whose insurance companies decided immediately to pay for Prevnar vaccinations could get the shot series for ...