ROTAVIRUS VACCINE SURVEY OF PEDIATRICIANS

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ROTAVIRUS VACCINE SURVEY OF PEDIATRICIANS

• Mehran S. Massoudi
• National Immunization Program
• ACIP/NVAC Workgroup Meeting
• May 9, 2002

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Collaborators

• Georgia and Wisconsin Chapters of the AAP
• Wisconsin Tom Saari, MD
• National Immunization Program
• Martha Iwamoto, MD
• Shawn McMahon, MD, MPH
• Mehran Massoudi, PhD, MPH
• Hussain Yusuf, MBBS, MPH
• John Stevenson, MA
• Susan Chu, PhD, MSPH
• Charles LeBaron, MD
• Larry Pickering, MD

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Rotavirus

• Most common cause of severe gastroenteritis in
  infants and young children
• Leading cause of physician visits and
  hospitalizations for diarrhea in the United
  States
• Major cause of child morbidity and mortality in
  developing countries

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Rotavirus VaccineA Brief History

• RRV-TV (RotaShield, rhesus-based rotavirus
  tetravalent vaccine) licensed by the FDA in
  August 1998
• Recommended by ACIP, AAP, and AAFP for routine
  use among infants
• Numerous reports of intussusception after
  administration of RRV-TV
• RRV-TV use suspended in July 1999
• RRV-TV voluntarily withdrawn from U.S. market in
  October 1999
• Withdrawal of original recommendations by ACIP,
  AAP, and AAFP

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Where are we now?

• On-going research and discussion on association
  between RRV-TV and intussusception
• New vaccines on the horizon
• Will manufacturers produce these vaccines?
• Will pediatricians use a rotavirus vaccine?

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Objectives

• To investigate if pediatricians would reconsider
  using RRV-TV or other, newer and safer rotavirus
  vaccines if they were recommended
• To identify factors influencing their opinion

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Survey Content

• Knowledge, Attitudes, and Practices
• Rotavirus disease
• Rotavirus vaccine
• Past practices
• Anticipated practices
• Influences on vaccine practices
• Methods of communication

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Methods

• Survey conducted by e-mail, fax, and postal mail
• Questionnaire with multiple choice and Likert
  scale questions
• Primary contact and reminders

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Survey Respondersand Eligibles
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Respondent Characteristics
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Respondent Characteristics
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Referrals to Hospital or ER for
vomiting/diarrheain the past year
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Attitudes aboutRotavirus Disease

• 79 of pediatricians surveyed agreed that
  rotavirus disease is a significant problem in the
  U.S.
• 95 considered rotavirus disease a significant
  problem world-wide

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Attitudes aboutRotavirus Vaccines

• 93 agreed that new rotavirus vaccines should be
  proven safer than RRV-TV
• 75 of Georgia pediatricians agreed that RRV-TV
  should be used in developing countries

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How would the followingimpact your decisionto
reintroduce a rotavirus vaccine?
Barriers
Advantages
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Comparative Safety Profile for a Rotavirus Vaccine
n258
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Would you giveRRV-TV today?
n 312
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Georgia
Wisconsin
Knowing RRV-TVs safety profile, would you give
it?
If RRV-TV were found safer, would you give it?
COID / ACIP Recommendation
COID / ACIP Recommendation
IS about 110,000 first doses of RRV-TV
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If there were a NEW, SAFER rotavirus vaccine,
would you give it?
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Summary

• 15 of pediatricians would use RRV-TV if it were
  available today
• 93 would use a new rotavirus vaccine if it were
  found safe and recommended for routine use by
  ACIP and AAP
• Routine recommendations are preferred over
  permissive recommendations
• Potential barriers include fear of adverse
  reactions, cost of the vaccine, and time needed
  to educate parents about vaccine

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Department of Health and Human Services
Questions