Attitudes and perceptions of private pediatricians regarding polio immunization in India

Background: India has faced considerable challenges in eradicating polio. Uttar Pradesh (UP) and Bihar are the two states in India where transmission of polio has never been interrupted. Private pediatricians are important stakeholders for vaccine delivery and maintaining public confidence in vaccines. The purpose of this study was to investigate the attitudes and perceptions of pediatricians in India regarding polio immunization and their opinions about various strategies regarding polio eradication in the country. Methods: A random sample of 785 pediatricians belonging to the Indian Academy of Pediatrics (IAP) were selected for the survey with over sampling of members located in Bihar and UP. Potential participants were either contacted by phone or sent a self-administered anonymous questionnaire by mail. For this analysis both sets of responses were combined. Surveys were conducted from June 2009 to June 2010. Results: A total of 398 surveys were completed (51%). Nearly all respondents indicated that polio eradication is still an important priority (99.7%). Ninety-six percent of pediatricians believed that strengthening routine immunization efforts remains the best way to eradicate polio in endemic areas. Other measures thought to be important in eradicating polio are mass campaigns with IPV (73%) and mass campaigns with bivalent OPV (59%). Pediatricians also identified several barriers to polio eradication which included parents' lack of awareness of the importance of polio vaccination (88.8%), parents' lack of confidence in polio vaccine (64.0%), religious beliefs (59.2%), fear of side effects (59.2%), lack of time or priority (56.6%), superstition (50.3%) and cultural beliefs (46.4%). Conclusion: There is still strong support for polio eradication efforts among IAP members. Pediatricians in India strongly believe that improving the coverage of routine immunization remains the best way to eradicate polio. There is an urgent need to improve awareness, build confidence in the program, and remove barriers among parents. (C) 2011 Elsevier Ltd. All rights reserved.