Both closed (dichotomous and multiple-choice) and free text questions were employed. In July 2009, all YFVCs (n = 3,465) in EWNI were requested to complete the questionnaire. They were informed via a newsletter sent to YFVCs, on Angiogenesis inhibitor the NaTHNaC website, by email and for centers without known email addresses, by post. Email and postal reminders were sent out over a period of 4 months. Centers could complete the questionnaire electronically or print it and return it by post. YFVCs were informed that their responses would be analyzed in aggregate

and not linked to individual centers. Responses received by post were entered manually into Survey Monkey®. Results were exported into Microsoft Excel® for data cleaning, and data analyzed in STATA 9®. Free text answers were reviewed and grouped into new or existing answer categories. Data were analyzed using chi-squared tests, tests of proportions, and correlation coefficients. Where possible, responses reported in this current survey were compared qualitatively to those from the 2005 survey

with description of trends.17 Of the 3,465 YFVCs in EWNI in July 2009, a total of 1,454 centers responded to the questionnaire, with 1,438 centers completing the entire survey (41.5%). Response rates to individual questions ranged from 72.6% signaling pathway to 99.9%. The proportion of YFVCs completing questionnaires by geographic area (postcode area) was relatively uniform with 71.6% of areas having a completion proportion between 31 and 50%; 92.9% of responses were from YFVCs in England, comparable to the percent of all YFVCs in England

which was 90.0%. Most YFVCs that responded were General Practices (GP) (87.4%), and the person completing the questionnaire was usually the nurse responsible for the YFVC (41.8%) or a practice nurse working in the YFVC (43.0%) (Table CYTH4 2). Nearly all YFVCs (97.0%) had one or more nurses who administered YF vaccine; only 24.2% of centers had one or more physician administering YF vaccine (p < 0.0005). In addition, 97.0% of centers had nurses who advised travelers, whereas only 36.5% of centers had physicians advising travelers (p < 0.0005). A reduction was observed in the proportion of physicians administering YF vaccine (24.2% vs 48.7%) and advising travelers (35.5% vs 52.6%) compared to the baseline study. In the UK, nurses usually work under the specific direction of the lead physician. There was a wide range in the number of doses of YF vaccine given by YFVCs (Figure 1). The median number of doses was 50 per year [inter-quartile range (IQR) 30–75 doses], more than the baseline survey (median of 35 doses per year). The number of doses of YF vaccine given differed significantly by clinic type (p < 0.