Physician preferences for attributes of pediatric combination vaccines in the United States

Abstract

Objective

To understand physician preferences for various attributes of pediatric combination vaccines.

Methods

An online survey was completed by 400 US physicians (pediatricians and family physicians) who routinely administer vaccines to infants aged 1–12 months in outpatient settings. Respondents completed a discrete choice experiment (DCE) by selecting their preferred options from different hypothetical vaccine profiles with systematic variation in the levels of five attributes: vaccine presentation, number of injections administered at a single visit, completion rates, timeliness rates (within 30 days of recommended age), and years of availability for routine use, assuming similar cost, safety, and efficacy. Odds ratios and relative attribute importance scores were estimated using a random parameters logit model.

Results

Physicians (mean age 50.4 years, 52.5% women) preferred combination vaccines that reduced the number of injections administered at a single visit, facilitated higher completion and timeliness rates for the primary DTaP series, were available as a pre-filled syringe rather than a vial needing reconstitution and had been available for routine use for more than 1 year. All odds ratios were statistically significant. Physicians were twice as likely to prefer administering three injections in a single visit instead of four. The most important attribute was the number of injections administered at a single visit (relative importance 38%), followed by timeliness, completion rates, and vaccine presentation; years a vaccine has been available was the least important attribute.

Conclusion

US physicians prefer pediatric combination vaccines that enable fewer injections to be administered at a single visit, facilitate higher completion and timeliness rates, are offered as a pre-filled syringe, and have been available for routine use for more than 1 year. The most important attribute of pediatric combination vaccines was a reduction in the number of injections administered at a single visit.

Keywords:

• Pediatric vaccines
• preference
• decision making
• discrete choice experiment (DCE)
• pediatricians
• family physicians
• combination vaccines

Transparency

Declaration of funding

MSP Vaccine Company is funded by a partnership between Merck Sharp & Dohme LLC., a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, and Sanofi Inc., Swiftwater, PA, USA.

Declaration of financial/other relationships

SS, TP, and AH are employees of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, and own stock in Merck & Co., Inc., Rahway, NJ, USA. MM and CBN are employees of Sanofi Swiftwater, PA, USA. At the time of this study, JA, EZ, and AP were employees of OPEN Health, an institution that received funding from MSP Vaccine Company. GSM has been an investigator on clinical trials funded by GlaxoSmithKline, Merck, Novartis, Pfizer, Sanofi and Seqirus, and has received honoraria from these companies for service on advisory boards and honoraria from Pfizer and Sanofi for non-branded presentations.

All authors have no other conflicts of interest to disclose. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Authors contributions

SS, TP, AH, EZ, JZ, MM, CBN, and GSM contributed to the study design and survey development. EZ, JA, and AP helped deploy the survey and generate results. All authors were involved in the interpretation of the results. SS, TP, JA, and AP drafted the manuscript. AH, EZ, MM, CBN, and GSM provided comments and interpretation.

Acknowledgements

The authors wish to thank Jenna Bhaloo for her contribution to survey design, Ning Ning for statistical analysis, and Jordana Schmier for her manuscript writing.

Data availability statement

The data that supports the findings of this study are available from the corresponding author, SS, upon reasonable request.