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Irradiation of fresh meat to control microbial pathogens received approval from the federal government in February 2000. Food irradiation is a useful, albeit underutilized, process that can help protect the public from foodborne illnesses. The objective of this study was to determine consumer knowledge, attitudes, and practices toward irradiated meat products. Data were obtained from a single-stage random-digit dialing telephone survey of residents of the Foodborne Diseases Active Surveillance Network (FoodNet) sites conducted in 2002 to 2003, which included supplemental questions about food safety and irradiated meat for residents of the Connecticut and New York sites. Thirty-seven percent of 3,104 respondents knew that irradiated fresh meat was available for purchase; however, only 2% found the product where they shopped. Knowledge of product availability was significantly influenced by whether a respondent lived in a county with one or more grocery stores operated by chain A, which had actively promoted the sale of irradiated fresh ground beef during the survey period. In a logistic regression model, after adjusting for other factors, respondents living in a county with chain A were more likely to know that irradiated products could be purchased than respondents living in other counties (odds ratio 2.0; 95% confidence interval 1.5 to 2.5). This finding suggests that public education efforts by an individual grocery store chain can have an important effect on knowledge of irradiated food.

Background. A national shortage of heptavalent pneumococcal conjugate vaccine (PCV7) occurred from September 2001 through May 2003. In December 2001 and January 2002, the Advisory Committee on Immunization Practices and the American Academy of Pediatrics (AAP) issued PCV7-shortage recommendations, emphasizing that all health care providers decrease the number of doses for healthy children so that more children could receive some PCV7. Objectives. We assessed (1) how the PCV7 shortage affected pediatricians, (2) whether children in the public and private sectors were vaccinated differently during the shortage, (3) pediatricians' knowledge of and adherence to the Advisory Committee on Immunization Practices/AAP recommendations, (4) and what factors were associated with nonadherence to the recommendations. Methods. We conducted a cross-sectional mail survey of 2500 US physician-members of the AAP from November 2002 through March 2003; physicians providing childhood immunizations were eligible. We asked about PCV7-shortage experience, assessed recommendation adherence through clinical scenarios, and modeled potential factors associated with reported nonadherence to the recommendation to defer the fourth PCV7 dose. Results. Of 2478 surveys sent to valid addresses, 1412 (57%) completed surveys were received; 946 (67%) of these were from eligible pediatricians. Overall, 79% experienced a PCV7 shortage, 94% reported being aware of the recommendations, and 42% reported barriers to recommendation adherence. Ninety-four percent reported vaccinating 6-month-old infants with private or public insurance in the same manner. As recommended, 91% reported fully vaccinating high-risk patients. Contrary to recommendations, 49% reported sometimes or always administering the fourth PCV7 dose to healthy children 12 to 15 months old; their reasons included recurrent otitis media, childcare attendance, and parental desire. Controlling for other characteristics, pediatricians who had no PCV7 shortage in their practices were significantly more likely to report administering the fourth dose than pediatricians who had a shortage (odds ratio [OR]: 3.67; 95% confidence interval [CI]: 2.40–5.63). Other factors associated with nonadherence were being in solo private practice (OR: 2.18; 95% CI: 1.26–3.77) or being male (OR: 1.51; 95% CI: 1.08–2.12). Among pediatricians deferring PCV7, 36% reported having no system to track children for whom PCV7 was deferred. Conclusions. Many pediatricians, both with and without a PCV7 shortage, administered more PCV7 doses than recommended. Pediatricians without a shortage were less likely to limit use, which suggests that they might have focused on the perceived value of administering the full schedule to their patients in preference to broader public health goals. Providing more information to physicians on the effectiveness of a fewer-dose schedule and the risk of disease when vaccine is deferred and educating parents might increase adherence to recommendations and achieve more equitable coverage during vaccine shortages.

OBJECTIVE: The objective of this study was to examine the relationship between social distance (measured as the geodesic, or shortest distance, between 2 people in a connected network) and geographic distance (measured as the actual distance between them in kilometers [km]). STUDY: We used data from a study of 595 persons at risk for HIV and their sexual and drug-using partners (total N = 8920 unique individuals) conducted in Colorado Springs, Colorado, from 1988 to 1992--a longitudinal cohort study that ascertained sociodemographic, clinical, behavioral, and network information about participants. We used place of residence as the geographic marker and calculated distance between people grouped by various characteristics of interest. RESULTS: Fifty-two percent of all dyads were separated by a distance of 4 km or less. The closest pairs were persons who both shared needles and had sexual contact (mean = 3.2 km), and HIV-positive persons and their contacts (mean = 2.9). The most distant pairs were prostitutes and their paying partners (mean = 6.1 km). In a connected subset of 348 respondents, almost half the persons were between 3 and 6 steps from each other in the social network and were separated by a distance of 2 to 8 km. Using block group centroids, the mean distance between all persons in Colorado Springs was 12.4 km compared with a mean distance of 5.4 km between all dyads in this study (P