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Paediatricians’ misconceptions on childhood immunisations
  1. E Stathopulu
  1. Consultant Community Paediatrician, Medway Maritime Hospital, Gillingham ME7 5NY, UK

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Suboptimal immunisation practices of health care providers, mainly overly cautious interpretation of vaccine contraindications, result in missed opportunities for immunisation.1 In an attempt to identify deficiencies and misconceptions in the knowledge on childhood immunisations of community and hospital based paediatricians, with the purpose to plan appropriate teaching sessions, a quiz was developed from the common questions that I, as District Immunisation Coordinator,2 was asked. It was presented as short case studies, each having a number of answers to be marked as true or false, and validated by reference to Immunisations against infectious disease3 and current UK immunisation guidelines. The quiz was handed out before the training sessions on childhood immunisations in two districts and in the regional training session for “core” specialist registrars in paediatrics (first and second year).

Twenty four of 35 (69%) participants were junior doctors and 11 (31%) career paediatricians (staff grade, associate specialists, and consultants). Fifteen (43%) had more than four years experience in paediatrics. The sample of paediatricians was representative of the team of career and training paediatricians in district hospital and community paediatric departments. The percentage of correct answers per participant varied between 36% and 92% (mean 70.66%). The results showed that paediatricians, both career and in training, had a number of misconceptions about contraindications of childhood immunisations. The most problematic area was the advice given after local and generalised reaction following DTP/Hib combined in one injection. In addition there was marked overestimation of a mild to moderately severe local reaction as severe, regarded as contraindication to immunise. Those with longer experience in paediatrics did not have less misconceptions, suggesting that all paediatricians require in depth discussion and regular update of the childhood immunisation schedule, contraindications to immunise, and how to manage missed immunisations.