Biomedical subjects

Pamela L Y H Ching

Publications and source records attributed to Pamela L Y H Ching.

3 recordsLinked to original sources

PubMed2006

Uptake of varicella vaccination among young children in the United States: a success story in eliminating racial and ethnic disparities.

OBJECTIVE: To examine uptake of varicella vaccine, a live attenuated vaccine licensed in 1995 and recommended in 1996 for routine vaccination of US children 12 to 18 months of age. METHODS: Data were for 178,616 children (19-35 months of age) and were collected in the 1997 to 2004 National Immunization Survey. The main outcome measures were estimated varicella vaccine coverage from 1997 to 2004, coverage among susceptible children (ie, those without a history of varicella disease), racial/ethnic disparities, risk factors for nonvaccination, missed opportunities to vaccinate simultaneously with other recommended vaccines, and projected increases in coverage after elimination of missed opportunities for simultaneous vaccination. RESULTS: Varicella vaccine coverage rates increased from 26% in 1997 to 87% in 2004. State-specific coverage rates increased 44 to 80 percentage points and were >80% in 42 states and >90% in 13 states by 2004. Coverage among susceptible children increased from 62% in 1999 to 88% in 2004. From 1998 onward, no statistically significant differences in coverage were found between white and black children, whereas Hispanic children had higher coverage rates than white children in 1998 to 2001 and 2004. Risk factors for undervaccination included living in the Midwest region, living in a household with >1 child, living in nonmetropolitan areas, living below the poverty level, having a mother who did not have a college degree, and having public providers. If missed opportunities for simultaneous vaccination had been eliminated, then coverage rates would have increased from 58% to 94% in 1999 and from 87% to 96% in 2004. CONCLUSIONS: Uptake of varicella vaccine has been steady and is an example of successful elimination of racial and ethnic disparities. Additional focus should be placed on reducing missed opportunities for simultaneous vaccination, improving coverage in rural areas and the Midwest region, and closing remaining gaps related to maternal education, provider type, and multiple-children households.

Chickenpox↗

PubMed2005

Willingness of private physicians to be involved in smallpox preparedness and response activities.

BACKGROUND: The public health system continues its efforts to prepare for bioterrorist events, such as a smallpox outbreak, but may need to call on other health professionals to ensure sufficient capacity to implement preparedness plans. OBJECTIVE: The goal was to understand the willingness of primary care physicians to participate in possible smallpox pre- or post-event activities. METHODS: A 23-question mail survey was sent to a national random sample of 727 internists and 720 family physicians. After three mailings, a one-page version of the survey was sent to nonrespondents. RESULTS: Response rates were 26% for questions common to both surveys and 22% for questions on the longer survey only. Respondents to the survey expressed moderate support for participating in certain smallpox pre- and post-event activities. Under a pre-event scenario, many providers would be willing to vaccinate first responders in their practice, and roughly one-third would be willing to vaccinate patients in their practice or to work in a public health clinic as a vaccinator. Most physicians, however, would be unwilling to be vaccinated themselves. Under post-event conditions, most providers would be willing to vaccinate their own patients, and many would vaccinate other community members in their practice. CONCLUSIONS: Despite the low response rate, information from this study on the smallpox preparedness activities in which physicians are most willing to participate can help to inform efforts by public health officials and private physicians to collaborate on bioterrorism preparedness efforts.

Adult↗

PubMed2005

Hospital decision-making regarding the smallpox pre-event vaccination program.

OBJECTIVES: To understand the factors underlying the decision by U.S. hospitals to participate or not in the U.S. Smallpox Pre-Event Vaccination Program (SPVP). METHODS: We conducted semistructured telephone interviews with a convenience sample of 123 hospital decision-makers in nine states between June and November 2003. RESULTS: Within our sample, 88 hospitals (72%) decided to participate in the SPVP and 35 (28%) decided against doing so. Nearly all hospital decision-makers considered the risk of a smallpox outbreak, risks associated with vaccination, hospital costs, and the reaction of hospital stakeholders. However, these factors often were weighed differently by hospitals that decided to participate compared to those that did not. Fewer than half of all hospitals reported that public health officials played an important role in their decision-making process, but those that did felt the influence of public health officials was positive. CONCLUSIONS: Strengthening the linkage between the public and private health sectors may help to address some of the barriers to broader participation by hospitals in the SPVP and foster the success of smallpox outbreak response preparedness efforts in the future.

Community-Institutional Relations↗