A Look at the Pediatrician as Parent: Experiences with the Introduction of Varicella Vaccine

Many physicians voiced reservations about routine use of the varicella vaccine for healthy children after its licensing in 1995. Anecdotal evidence suggested that some pediatricians who were parents themselves were electing not to vaccinate their own children against chickenpox. Little has been written about pediatrician-parents' behaviors in caring for their own children, and how these practices may differ from the behavior that these same pediatricians apply in practice. Pediatricians' tacit attitudes toward medical interventions might be better understood from their behaviors as parents than from their clinical practices, which may be influenced by a sense of responsibility to follow guidelines of professional organizations. Varicella vaccination practices were examined to determine whether pediatricians' behaviors in parenting their own children differed from their recommendations for their patients. A mail survey was sent to 1,762 New York State pediatricians selected randomly from the membership directory of the American Academy of Pediatrics. The response rate was 43% (764/1,762); 63% of responding pediatricians were parents. Eighty-five percent of pediatricians recommended varicella vaccine routinely in practice. Of the pediatricians' own eligible children, 88% (256/291) had been vaccinated against chickenpox. We found a high overall rate of compliance with recommendations for routine use of varicella vaccine. Pediatricians who were parents were just as likely as nonparent pediatricians to recommend the vaccine routinely for their patients. Importantly, pediatrician-parents demonstrated no "double standard"; at the time of the study, 88% of pediatricians' own eligible children had been vaccinated against varicella.