Surveys were sent in November–December, 2005, to representative samples of providers of influenza vaccine within major national professional organizations. Providers sampled included pediatricians, internists, visiting nurse organizations, providers in federally qualified health centers, and state and other health departments directly receiving federal immunization funds (grantees). Results from other professional organizations surveyed (ie, The American Association of Family Physicians, The National Association of County and City Health Officers, Community Vaccinator groups, Occupational Health groups, the American Pharmacists Association, and the American Hospital Association) are not presented because of limited response rates.
Surveys were sent to a subset (283) of a sentinel network of 431 pediatricians selected from a random sample of 2,500 members of the American Academy of Pediatricians (AAP), representative of AAP membership overall with respect to region, practice location, and practice setting. These 283 physicians were surveyed by email; within the sentinel physician network, physicians preferring to be surveyed by email were not statistically significantly different from those who preferred to be surveyed by regular mail. Those with a preference for email surveys were selected for this study because of their rapid response rate.
Surveys were sent to a subset (308) of a sample of 438 internists selected from a random sample of 3,000 members of the American College of Physicians (ACP), representative of members with respect to region, practice location, and practice setting. As above, these 308 physicians were surveyed by email; within the sentinel physician network, physicians preferring to be surveyed by email were not statistically significantly different from those who preferred to be surveyed by regular mail.
The Visiting Nurse Associations of America (VNAA), one of the community vaccinator organizations, surveyed all 154 member agencies via email. The survey for VNAA members was web based. It was directed to all members of the Visiting Nurse Associations of America. The recipient asked to complete the survey was the director of the immunization program in the agency.
The National Association of Community Health Centers (NACHC) randomly sampled 100 health centers from 919 health centers. Centers that were previously queried in early 2005 about influenza vaccine (n = 44) and centers for which there was no email address (n = 23) were excluded from the sampling frame. The survey for NACHC members was emailed to the contact of the randomly selected 100 members, directed to Health Center Colleague. They were asked to send the survey back to the Chief Medical Officer of NACHC.
The CDC emailed surveys to immunization program managers (grantees) in all 50 states, the District of Columbia, the Federated States of Micronesia, the Marshall Islands, Northern Marianas Islands (commonwealth), Palau, and U.S. territories, including Guam, Puerto Rico, American Samoa, and the Virgin Islands. Grantees were asked to respond for all VFC and non-VFC vaccine orders.
Respondents participating in the provider surveys in all groups were asked questions about their experience in ordering influenza vaccine, sources where orders were placed, proportion of orders received, if they had referred any priority group patients to another location due to inadequate vaccine supplies, and if they had encountered any further problems. The cutoffs for orders received were selected based on the expectation that ideally in mid-November, providers expected to have received 80% or more of vaccine ordered, and 40% is the minimum we judged to permit some vaccination programs to hold clinics and vaccinate in offices. Sixty percent was an estimate of Sanofi and Novartis vaccine delivery to customers based on what the companies had projected to deliver by the time of the survey earlier in the year.
The surveys of pediatricians and internists were conducted as part of an ongoing study approved by the Colorado Multi-Institutional Review Board. The other surveys in this report were undertaken as a response to a public health emergency and did not require a review by the CDC's Institutional Review Board and consent was not required.