Knowledge of medical specialists or medical specialist trainees about vaccinations not included in the official Certificate of Vaccination of Uruguay

Abstract

Introduction: the burden of vaccine preventable diseases in adults is high. Immunization is an effective strategy to prevent these diseases. However, immunization coverage is low.

Several studies evidence that ignorance of indications and contraindications for vaccinations, and failure of a recommendation for immunization by physicians constitute the main barriers.

Objective: to learn about medical specialists’ or medical specialists trainees’ knowledge on “non-systematic” vaccinations (NSV, these are the vaccinations that are not included in the Certificate of vaccination) in adults and their behavior in connection with their recommendation.

Method: descriptive, transversal study by means of a self-administered survey to medical specialists at the Clínica Hospital, between September and November, 2014. Convenience sampling, non-probability.

Results: 127 physicians were interviewed, 12 specializations were covered. When asked to name NSV, 102 (80%) replied adequately, 116 (91%) state they recommend them and 84 (66%) declare they create a space to discuss vaccinations. Those who fail to do so argue they forget (49%) and they lack the time (38%). 45% of physicians provide adequate or appropriate information in regards to vaccination indications. 35% of physicians provide adequate or appropriate information in regards to vaccination contraindications. The most frequent mistake was to state inactive vaccines were contraindicated for immunocompromised patients or patients suffering from non-severe acute diseases. Specialists recommend NSV to the specific population they see in 35% of cases.

Conclusions: the specialists surveyed evidenced poor knowledge about indications and contraindications of NSV, since less than 50% of them were aware of indication and only 35% of them were aware of the contraindications. Only 35% of physicians were familiar with NSV specific indications in their area of specialization.

False contraindications were the most frequent mistake, leading to lost opportunities for immunization.

These findings point out the need to improve the training of physicians’/specialists’ to achieve better immunization coverage.