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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

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.

Arch Pediatr Adolesc Med. 2001;155:1051-1056

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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@u.washington.edu).

Accepted for publication April 10, 2001.

This study was funded by the Ambulatory Pediatric Association's Special Project Grant for Immunization-Related Research, McLean, Va (Drs McPhillips, Davis, and Taylor).

 

 
© 2001 American Medical Association. All rights reserved.