FP3 Identifying and overcoming the obstacles to varicella vaccination. (Family Practice).

FP3 IDENTIFYING AND OVERCOMING THE OBSTACLES TO VARICELLA VACCINATION. Stephen Offord, MD, Ephraim Back, MD, and Gary Dunkerley, MD. St. Clare's Family Practice Residency Program, Schenectady, NY

We present a prospective clinical study to assess compliance with varicella vaccination before and after an educational program directed to health care providers within a residency family practice center. Before the vaccine, vancella was responsible for 11,000 hospitalizations and 100 deaths each year in the United States. A vaccine for vancella was licensed for use in the US in 1995. The CDC, AAP, and ACIP recommend vaccination for all children 13 and under without history of disease. Yet, there is evidence to suggest health care providers underestimate the importance of varicella vaccination. This is reflected in low rates of varicella vaccination beyond just the inherent lag-time in fully incorporating a new vaccine. By reducing the circulation of the wild stain, ineffective vaccination could actually increase the burden of disease. Our study was done in a residency-based family practice office with a total of 34 medical providers, which included 27 family practice residents, 3 physicians assistants, and 6 attending physicians. A survey was first conducted to assess our providers' knowledge of the disease and attitudes towards vaccination. A chart review was then conducted on a random sample of all charts for children aged 5 and under to determine the incidence of varicella vaccination compared with the incidence of other vaccinations. Educational intervention was then provided in the form of two lectures and the provision of guidelines. A colorful sticker (polka-dotted face) was then placed on all charts of children 5 and under as a reminder to address varicella vaccination status. Several months later, a second random chart sample was reviewed and the incidence of varicella vaccination was compared with the first. We will present data on our providers' attitudes towards varicella vaccination and on the impact of our interventions. In our survey, a significant number did not believe varicella was a serious disease and did not realize vaccination (or evidence of immunity) will be mandatory for children enterin g day care or elementary school. Documentation of vaccination in our office was indeed significantly lower for varicella compared with other vaccinations. After the interventions, there was a significant improvement in compliance with vaccination. The goal of the study was to assess attitudes towards varicella and compliance with vaccination. We found varicella was perceived as a benign disease, but that proper intervention can significantly increase awareness and compliance with vaccination.