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	Institution: CLOCKSS  | My Account | E-mail Alerts | Access Rights | Sign In Vol. 3 No. 7, July 1994   Archives  • Online Features Original Contributions  This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal Too Many Shots? Parent, Nurse, and Physician Attitudes Toward Multiple Simultaneous Childhood Vaccinations Diane J. Madlon-Kay, MD; Peter G. Harper, MD, MPH Arch Fam Med. 1994;3(7):610-613. Abstract Objective To learn about parent, nurse, and family physician attitudes toward multiple simultaneous childhood vaccinations. Design Survey. Setting Thirty-two family practice clinics in Minnesota. Patients/Participants Forty-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 Measures Number 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. Results Most 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 new-born 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. Conclusions Most 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. Author Affiliations From the Department of Family and Community Medicine, St Paul (Minn)—Ramsey Medical Center. THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES Financial Impact to Providers Using Pediatric Combination Vaccines Shen et al. Pediatrics 2011;128:1087-1093. ABSTRACT | FULL TEXT   A Web-based Tool for Designing Vaccine Formularies for Childhood Immunization in the United States Jacobson and Sewell J Am Med Inform Assoc 2008;15:611-619. ABSTRACT | FULL TEXT   Routine Immunization Practices: Use of Topical Anesthetics and Oral Analgesics Taddio et al. Pediatrics 2007;120:e637-e643. ABSTRACT | FULL TEXT   The Role Familiarity With Science and Medicine Plays in Parents' Decision Making About Enrolling a Child in Vaccine Research Chantler et al. Qual Health Res 2007;17:311-322. ABSTRACT   The Feasibility of Universal Influenza Vaccination for Infants and Toddlers Humiston et al. Arch Pediatr Adolesc Med 2004;158:867-874. ABSTRACT | FULL TEXT   Effect of Choice of Measles-Mumps-Rubella Vaccine on Immediate Vaccination Pain in Infants Ipp et al. Arch Pediatr Adolesc Med 2004;158:323-326. ABSTRACT | FULL TEXT   Clinician Satisfaction with Vaccination Visits and the Role of Multiple Injections, Results from the Covise Study (Combination Vaccines Impact on Satisfaction and Epidemiology) Meyerhoff et al. CLIN PEDIATR 2004;43:87-93. ABSTRACT   Variation in Clinician Recommendations for Multiple Injections During Adoption of Inactivated Polio Vaccine Lieu et al. Pediatrics 2001;107:e49-e49. ABSTRACT | FULL TEXT   Association Between Administration of Hepatitis B Vaccine at Birth and Completion of the Hepatitis B and 4:3:1:3 Vaccine Series Yusuf et al. JAMA 2000;284:978-983. ABSTRACT | FULL TEXT   Low immunisation uptake: Is the process the problem? Harrington et al. J. Epidemiol. Community Health 2000;54:394-394. ABSTRACT | FULL TEXT   Parental Compliance With Multiple Immunization Injections Melman et al. Arch Pediatr Adolesc Med 1999;153:1289-1291. ABSTRACT | FULL TEXT   Combination Vaccines for Childhood Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP) Committee on Infectious Diseases, 1998-1999 Pediatrics 1999;103:1064-1077. FULL TEXT   Vapocoolant Spray Is Equally Effective as EMLA Cream in Reducing Immunization Pain in School-aged Children Cohen Reis and Holubkov Pediatrics 1997;100:e5-e5. ABSTRACT | FULL TEXT   A National Survey to Understand Why Physicians Defer Childhood Immunizations Zimmerman et al. Arch Pediatr Adolesc Med 1997;151:657-664. ABSTRACT   Calculating a Clinic's Childhood Immunization Rate: Costs and Returns Chapman and Hacker Arch Fam Med 1995;4:625-627. ABSTRACT   HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | PHYSICIAN JOBS | HELP CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP   © 1994 American Medical Association. All Rights Reserved.