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Uptake of Adult Vaccination Varies Widely in Urban Areas

Study suggests physicians' practice characteristics affect how many people get vaccinated

TUESDAY, Nov. 10 (HealthDay News) -- There are wide variations in the uptake of pneumococcal polysaccharide vaccine (PPV) and influenza vaccine in adults in urban areas, and physicians' practice characteristics influence the likelihood of their patients getting vaccinated, according to a study in the November/December Annals of Family Medicine.

Richard K. Zimmerman, M.D., and colleagues at the University of Pittsburgh conducted a study of 2,021 patients aged 65 and over under the care of 30 physicians in 17 practices to see what effect patient-level characteristics and physician variables had on vaccination uptake rates.

The overall rate of PPV was 60 percent, but the rate ranged from 11 to 98 percent across physicians, the researchers found. The two physician variables with the strongest association with PPV were the time physicians spent with their patients and use of enhanced immunization documentation. The influenza vaccination rate was 51.9 percent, with a range of 22 to 96 percent. The two physician variables that were most strongly associated with influenza vaccination were "use of standing orders" and "average observed physician examination room time."

"Previous research has shown that vaccination rates vary by race and age, and level-one analyses confirmed those findings in these data," the authors write. "We also found that vaccination rates differed by physician and that, after controlling for race and age, longer reported well-visit length and enhanced vaccine documentation were associated with vaccination status for PPV, and use of standing orders and average observed physician examination room time were associated with influenza vaccination status."

Three of the study authors reported receiving funding from Merck & Co Inc. and MedImmune Inc.

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