Physician Knowledge and Attitudes about Hepatitis A and Current Practices Regarding Hepatitis A Vaccination Delivery

Abstract Objectives To assess physicians’ 1) knowledge and attitudes about hepatitis A disease and HepA vaccine, and 2) child care and school HepA vaccine mandates; 3) practices related to HepA vaccine delivery; 4) factors associated with strongly recommending HepA vaccine to all 1-2 year olds; and 5) feasibility of implementing HepA catch-up vaccination at health maintenance visits. Methods A national survey was conducted among representative networks of pediatricians and family medicine physicians (FMs) from March to June, 2014 by e-mail or mail based on provider preference. Results Response rates were 81% (356/440) among pediatricians and 75% (348/464) among FMs. Less than 50% correctly identified that hepatitis A virus (HAV) infection is usually asymptomatic in young children and that morbidity from HAV disease increases with age. Ninety-two percent of pediatricians and 59% of FMs strongly recommend HepA vaccine for all 1-2 year olds. In addition to practice specialty, belief that HepA vaccine is required for kindergarten enrollment was the most robust predictor of strong physician recommendation. Conclusion Gaps in knowledge regarding HAV infection and HepA recommendations and lack of a strong recommendation for routine HepA vaccination of young children among FMs likely contribute to suboptimal coverage. Closing knowledge gaps and addressing barriers that prevent all physicians from strongly recommending HepA vaccine to 1-2 year olds could help increase HepA vaccine coverage and ultimately improve population protection against HAV infection.