• D J Madlon-Kay and P G Harper.
• Department of Family and Community Medicine, St Paul, Minn-Ramsey Medical Center.
• Arch Fam Med. 1994 Jul 1; 3 (7): 610-3.

ObjectiveTo learn about parent, nurse, and family physician attitudes toward multiple simultaneous childhood vaccinations.DesignSurvey.SettingThirty-two family practice clinics in Minnesota.Patients/ParticipantsForty-six volunteer Minnesota Academy of Family Physicians Research Network members, 42 of their nurses, and 342 parents of their patients aged less than 6 years who have had at least one injection.Main Outcome MeasuresNumber of injections believed to be too many for a child to receive simultaneously and comfort level associated with children's receiving three simultaneous injectable vaccinations.ResultsMost parents, nurses, and physicians (71%, 76%, and 59%, respectively) think that three injections are too many for a child to receive at one visit. Similar percentages of parents, nurses, and physicians are uncomfortable with a child's receiving three injections at one visit. Sixty-seven percent of the physicians who do not offer universal newborn hepatitis B vaccinations cite the number of required simultaneous injections as a factor in that decision. Only 15% of physicians order all three recommended injections for most of their 15-month-old patients.ConclusionsMost parents, nurses, and physicians are uncomfortable with three simultaneous injections for children. This discomfort may be a significant barrier to the adoption of the new immunization recommendations. The development of effective combination vaccines should be a research priority.

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