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Vaccine
Safety
Survey Results:
State Vaccine Safety Activities
States Report
on Responding to Inquiries About Vaccine Safety
Background
Since 1999, the National Immunization
Program (NIP) has included questions on its annual survey of state
immunization program managers regarding the amount of time their
programs spend responding to vaccine safety inquiries and the specific
questions they most frequently receive. The most recent survey was
sent to states in December of 2001 and the data was collected by
NIP in March 2002. The program manager is responsible for completing
the survey, but may receive assistance from coordinators who may
be more familiar with the information relevant to certain sections
of the survey.
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Survey
Data
State immunization program managers were asked to report the types
and percentages of vaccine safety related public inquiries they
responded to in the past year. The proportion of participants who
reported that the focus of more than 15% of their public inquiries
were related to vaccine safety issues increased from 23% in 1999
to 35% in 2001. Forty-five percent of respondents in 2001 reported
that the number of vaccine safety questions they received from parents/general
public increased in the past year; 69% of respondents in 1999 and
70% of respondents in 2000 reported increases. Thirty-seven percent
of respondents in 2001 said that the number of questions they received
from health care professionals increased in the past year; 62% of
respondents in 1999 and 61% of respondents in 2000 reported increases.
Table 1:
State program managers reported increases in vaccine safety issues
in 1999, 2000 and 2001
|
% of state program managers who reported an INCREASE in the… |
1999 |
2000 |
2001 |
|
amount of time spent on vaccine safety issues |
NA |
70% |
43% |
|
number of parent and general public questions about vaccine safety |
69% |
70% |
45% |
|
number of provider questions about vaccine safety |
62% |
61% |
37% |
|
number of persons claiming religious or philosophical exemptions to
immunization |
18% |
31% |
34% |
|
Percentage of grantees who reported that parental concerns about vaccines
have affected overall immunization rates |
23% |
16% |
33% |
In 2001, program managers
reported that during the previous year the questions they most frequently
received about vaccines involved vaccine administration, schedules,
and storage1 (69%), vaccine exemptions (53%), additives in vaccines
(24%), contraindications to vaccination (20%), known side effects
(18%), individual antigen versus combination vaccines (18%), and
the effect of multiple vaccines on the immune system (14%). These
percentages are similar to those from the 1999 and 2000 surveys
with the exception that in 2000 the second most frequently received
question concerned the effect of multiple vaccines on the immune
system. Thirty-three percent of 2001 respondents indicated that
the effect of multiple vaccines was the most difficult issue to
address, followed by questions regarding vaccine additives (18%),
administration, scheduling and storage (18%), exemptions (12%),
unproven side effects (12%), and contraindications (7%). By comparison,
in 2000 'unproven side effects' was indicated by 63% of respondents
as the most difficult issue to address (the effect of multiple vaccines
was reported as the third most difficult issue).
Table 2: Types of vaccine safety questions that were the
most difficult to address during 2000 and 2001 (1999 data not
available)
| |
2000 |
2001 |
| Additives in vaccines |
15% |
18% |
| Contraindications to vaccines |
2% |
7% |
| Effect of multiple vaccines
on the immune system |
10% |
33% |
| Unproven side effects |
63% |
12% |
| Vaccine exemptions |
4% |
12% |
| Vaccine administration, schedules
and storage |
2% |
18% |
No program manager
reported a decrease in religious or philosophical exemptions in
2001, and 34% of respondents reported an increase; results from
the previous two years were similar. Finally, a higher percentage
of respondents in 2001 (33%) than in 1999 (23%) or 2000 (16%) reported
that parental concerns about vaccines and vaccine safety affected
overall immunization rates for their state.
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Conclusion
Clearly, the art of addressing vaccine safety concerns through effective
risk communication has emerged as, and continues to be, an increasingly
important skill for managers of mature immunization programs. Visit
the NIP website http://www.cdc.gov/nip
for information that may assist immunization programs in addressing
some of the difficult vaccine safety issues such as vaccine ingredients,
the effect of multiple vaccines on the immune system, and vaccine
administration, schedules and storage.
1 The category 'administration,
schedules and storage' included vaccine shortages and delays; these
issues were not a separate option. |
