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The Rotavirus Vaccine's Withdrawal and Physicians' Trust in Vaccine Safety Mechanisms
Heather A. McPhillips, MD, MPH;
Robert L. Davis, MD, MPH;
Edgar K. Marcuse, MD, MPH;
James A. Taylor, MD
Arch Pediatr Adolesc Med. 2001;155:1051-1056.
Objective To determine how the withdrawal from the market of the rotavirus vaccine
has affected physicians' trust in vaccine safety mechanisms, future adherence
to vaccine recommendations, and willingness to use a new rotavirus vaccine.
Design National survey mailed to 1228 randomly selected pediatricians and family
physicians.
Main Outcome Measures Confidence in vaccine safety mechanisms was defined by agreement with
the statements that the system for determining vaccine safety before a vaccine
is licensed works well and that the system for monitoring vaccine safety after
vaccine licensure works well. Physicians who indicated that they would use
a new rotavirus vaccine within 1 year of licensure and recommendation by professional
organizations were classified as "early adopters." Logistic regression was
used to assess the relationship between trust in vaccine safety mechanisms
and future early adoption of new rotavirus vaccines.
Results Following the withdrawal of the rotavirus vaccine, 83% of respondents
believed the postlicensure surveillance system works well to monitor vaccine
safety, while 22% of respondents believed the prelicensure system works well
to determine vaccine safety. After adjusting for physician specialty and years
in practice, respondents who believed the prelicensure vaccine safety system
works well were significantly more likely to be early adopters than those
with less confidence in prelicensure studies (adjusted odds ratio, 2.2 [95%
confidence interval, 1.3-3.6]).
Conclusions Physicians have different levels of trust in prelicensure studies that
determine vaccine safety and postlicensure surveillance systems that monitor
vaccine safety. Trust in prelicensure vaccine safety evaluations may be associated
with early adherence to new vaccine recommendations.
From the Child Health Institute (Drs McPhillips, Davis, and Taylor),
the Department of Pediatrics, School of Medicine (Drs McPhillips, Davis, Marcuse,
and Taylor), and the Department of Epidemiology, School of Public Health and
Community Medicine (Drs Davis and Marcuse), University of Washington, and
the Children's Hospital and Regional Medical Center (Drs McPhillips and Marcuse),
Seattle.
Corresponding author and reprints: Heather McPhillips, MD, MPH, Department
of Pediatrics, University of Washington, 4800 Sand Point Way NE, PO Box 5371,
Mail stop CH-30, Seattle, WA 98105 (e-mail: hmcphil{at}u.washington.edu).
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