1887
Research article Open Access
Like 0

Abstract

This article sought to estimate the prevalence of vaccine hesitancy (VH) among French general practitioners (GPs) and to study its demographic, professional and personal correlates. We conducted a cross-sectional telephone survey about GPs’ vaccination-related attitudes and practices in 2014 in a national panel of 1,712 GPs in private practice, randomly selected from an exhaustive database of health professionals in France. A cluster analysis of various dimensions of VH (self-reported vaccine recommendations, perceptions of vaccine risks and usefulness) identified three clusters: 86% of GPs (95% confidence interval (CI): 84–88) were not or only slightly vaccine-hesitant, 11% (95% CI: 9–12) moderately hesitant and 3% (95% CI: 3–4) highly hesitant or opposed to vaccination. GPs in the latter two clusters were less frequently vaccinated and reported occasional practice of alternative medicine more often than those in the first cluster; they also described less experience with vaccine-preventable diseases and more experience with patients who they considered had serious adverse effects from vaccination. This study confirms the presence of VH among French GPs but also suggests that its prevalence is moderate. Given GPs’ central role in vaccination, these results nevertheless call for a mobilisation of stakeholders to address VH among GPs.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2016.21.47.30406
2016-11-24
2017-10-19
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2016.21.47.30406
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/21/47/eurosurv-21-30406-4.html?itemId=/content/10.2807/1560-7917.ES.2016.21.47.30406&mimeType=html&fmt=ahah

References

  1. Larson HJ, Jarrett C, Eckersberger E, Smith DMD, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007-2012. Vaccine. 2014;32(19):2150-9.  https://doi.org/10.1016/j.vaccine.2014.01.081  PMID: 24598724 
  2. MacDonald NESAGE Working Group on Vaccine Hesitancy. Vaccine hesitancy: Definition, scope and determinants. Vaccine. 2015;33(34):4161-4.  https://doi.org/10.1016/j.vaccine.2015.04.036  PMID: 25896383 
  3. Gust DA, Darling N, Kennedy A, Schwartz B. Parents with doubts about vaccines: which vaccines and reasons why. Pediatrics. 2008;122(4):718-25.  https://doi.org/10.1542/peds.2007-0538  PMID: 18829793 
  4. Freed GL, Clark SJ, Cowan AE, Coleman MS. Primary care physician perspectives on providing adult vaccines. Vaccine. 2011;29(9):1850-4.  https://doi.org/10.1016/j.vaccine.2010.12.097  PMID: 21216314 
  5. Schwarzinger M, Verger P, Guerville MA, Aubry C, Rolland S, Obadia Y, et al. Positive attitudes of French general practitioners towards A/H1N1 influenza-pandemic vaccination: a missed opportunity to increase vaccination uptakes in the general public? Vaccine. 2010;28(15):2743-8.  https://doi.org/10.1016/j.vaccine.2010.01.027  PMID: 20117271 
  6. Ecole des Hautes Etudes en Santé Publique (EHESP). Faciliter l’accès aux vaccinations en s’appuyant sur les Agences Régionales de Santé. [Facilitate access to vaccinations with the support of the Regional Health Agencies]. Rennes: EHESP; 2013. French. Available from: http://fulltext.bdsp.ehesp.fr/Ehesp/Memoires/mip/2013/groupe_8.pdf
  7. Dubé E, Laberge C, Guay M, Bramadat P, Roy R, Bettinger J. Vaccine hesitancy: an overview. Hum Vaccin Immunother. 2013;9(8):1763-73.  https://doi.org/10.4161/hv.24657  PMID: 23584253 
  8. Daley MF, Crane LA, Markowitz LE, Black SR, Beaty BL, Barrow J, et al. Human papillomavirus vaccination practices: a survey of US physicians 18 months after licensure. Pediatrics. 2010;126(3):425-33.  https://doi.org/10.1542/peds.2009-3500  PMID: 20679306 
  9. Verger P, Flicoteaux R, Schwarzinger M, Sagaon-Teyssier L, Peretti-Watel P, Launay O, et al. Pandemic Influenza (A/H1N1) Vaccine Uptake among French Private General Practitioners: A Cross Sectional Study in 2010. McVernon J, editor. PLoS ONE. 2012;7(8):e41837.
  10. Poland GA. The 2009-2010 influenza pandemic: effects on pandemic and seasonal vaccine uptake and lessons learned for seasonal vaccination campaigns. Vaccine. 2010;28(Suppl 4):D3-13.  https://doi.org/10.1016/j.vaccine.2010.08.024  PMID: 20713258 
  11. Bish A, Yardley L, Nicoll A, Michie S. Factors associated with uptake of vaccination against pandemic influenza: a systematic review. Vaccine. 2011;29(38):6472-84.  https://doi.org/10.1016/j.vaccine.2011.06.107  PMID: 21756960 
  12. Haviari S, Bénet T, Saadatian-Elahi M, André P, Loulergue P, Vanhems P. Vaccination of healthcare workers: A review. Hum Vaccin Immunother. 2015;11(11):2522-37.  https://doi.org/10.1080/21645515.2015.1082014  PMID: 26291642 
  13. Verger P, Fressard L, Collange F, Gautier A, Jestin C, Launay O, et al. Vaccine Hesitancy Among General Practitioners and Its Determinants During Controversies: A National Cross-sectional Survey in France. EBioMedicine. 2015;2(8):891-7.  https://doi.org/10.1016/j.ebiom.2015.06.018  PMID: 26425696 
  14. Peretti-Watel P, Larson HJ, Ward JK, Schulz WS, Verger P. Vaccine hesitancy: clarifying a theoretical framework for an ambiguous notion. PLoS Curr. 2015;7:ecurrents.outbreaks.6844c80ff9f5b273f34c91f71b7fc289.
  15. Le Maréchal M, Collange F, Fressard L, Peretti-Watel P, Sebbah R, Mikol F, et al. Design of a national and regional survey among French general practitioners and method of the first wave of survey dedicated to vaccination. Med Mal Infect. 2015;45(10):403-10.  https://doi.org/10.1016/j.medmal.2015.09.005  PMID: 26494319 
  16. Kaufman L, Rousseeuw PJ. Finding Groups in Data: An Introduction to Cluster Analysis. Hoboken: John Wiley and Sons; 1990.
  17. Greenacre M. Correspondence analysis in medical research. Stat Methods Med Res. 1992;1(1):97-117.  https://doi.org/10.1177/096228029200100106  PMID: 1341654 
  18. Antón-Ladislao A, García-Gutiérrez S, Soldevila N, González-Candelas F, Godoy P, Castilla J, et al. Visualizing knowledge and attitude factors related to influenza vaccination of physicians. Vaccine. 2015;33(7):885-91.  https://doi.org/10.1016/j.vaccine.2014.12.012  PMID: 25529290 
  19. Ward JH Jr. Hierarchical Grouping to Optimize an Objective Function. J Am Stat Assoc. 1963;58(301):236-44 . https://doi.org/10.1080/01621459.1963.10500845 
  20. Peterson B, Harrell FE. Partial Proportional Odds Models for Ordinal Response Variables. Appl Stat. 1990;39(2):205 . https://doi.org/10.2307/2347760 
  21. Rogerson P. Statistical Methods for Geography. London: SAGE; 2011.
  22. Heckman J. Sample selection bias as a specification error. Econometrica. 1979;47(1):153-61 . https://doi.org/10.2307/1912352 
  23. Greene W. Econometric Analysis. Upper Saddle River, N.J.: Prentice Hall; 2003.
  24. Peretti-Watel P, Verger P, Raude J, Constant A, Gautier A, Jestin C, et al. Dramatic change in public attitudes towards vaccination during the 2009 influenza A(H1N1) pandemic in France. Euro Surveill. 2013;18(44):20623.  https://doi.org/10.2807/1560-7917.ES2013.18.44.20623  PMID: 24176658 
  25. Wheeler M, Buttenheim AM. Parental vaccine concerns, information source, and choice of alternative immunization schedules. Hum Vaccin Immunother. 2013;9(8):1782-9.  https://doi.org/10.4161/hv.25959  PMID: 23900266 
  26. Barlet M, Coldefy M, Collin C, Gabrielli VL. L’Accessibilité potentielle localisée (APL): une nouvelle mesure de l’accessibilité aux soins appliquée aux médecins généralistes libéraux en France [Internet]. Paris: IRDES; 2012 [cited 2016 May 30]. Available from: https://ideas.repec.org/p/irh/wpaper/dt51.html
  27. Pulcini C, Massin S, Launay O, Verger P. Factors associated with vaccination for hepatitis B, pertussis, seasonal and pandemic influenza among French general practitioners: a 2010 survey. Vaccine. 2013;31(37):3943-9.  https://doi.org/10.1016/j.vaccine.2013.06.039  PMID: 23806242 
  28. Downey L, Tyree PT, Huebner CE, Lafferty WE. Pediatric vaccination and vaccine-preventable disease acquisition: associations with care by complementary and alternative medicine providers. Matern Child Health J. 2010;14(6):922-30.  https://doi.org/10.1007/s10995-009-0519-5  PMID: 19760163 
  29. Brownlie J, Howson A. ‘Between the demands of truth and government’: health practitioners, trust and immunisation work. Soc Sci Med. 2006;62(2):433-43.  https://doi.org/10.1016/j.socscimed.2005.05.033  PMID: 16046042 
  30. Vorsters A, Tack S, Hendrickx G, Vladimirova N, Bonanni P, Pistol A, et al. A summer school on vaccinology: Responding to identified gaps in pre-service immunisation training of future health care workers. Vaccine. 2010;28(9):2053-9.  https://doi.org/10.1016/j.vaccine.2009.12.033  PMID: 20038430 
  31. Miller E, Andrews N, Stellitano L, Stowe J, Winstone AM, Shneerson J, et al. Risk of narcolepsy in children and young people receiving AS03 adjuvanted pandemic A/H1N1 2009 influenza vaccine: retrospective analysis. BMJ. 2013;346(feb26 2):f794–f794.
  32. Larson H, Karafillakis E. Vaccine Hesitancy amongst Healthcare Workers and Their Patients in Europe : A Qualitative Study - Vaccine Confidence Project. London: London School of Hygiene and Tropical Medicine; 2015.
  33. Joyce CM, Scott A, Jeon S-H, Humphreys J, Kalb G, Witt J, et al. The "medicine in Australia: balancing employment and life (MABEL)" longitudinal survey--protocol and baseline data for a prospective cohort study of Australian doctors’ workforce participation. BMC Health Serv Res. 2010;10(1):50.  https://doi.org/10.1186/1472-6963-10-50  PMID: 20181288 
  34. Brien S, Kwong JC, Buckeridge DL. The determinants of 2009 pandemic A/H1N1 influenza vaccination: a systematic review. Vaccine. 2012;30(7):1255-64.  https://doi.org/10.1016/j.vaccine.2011.12.089  PMID: 22214889 
  35. Llupià A, García-Basteiro AL, Mena G, Ríos J, Puig J, Bayas JM, et al. Vaccination Behaviour Influences Self-Report of Influenza Vaccination Status: A Cross-Sectional Study among Health Care Workers. Caylà JA, editor. PLoS ONE. 2012;7(7):e39496.
  36. MacDonald NE, Dubé E. Unpacking Vaccine Hesitancy Among Healthcare Providers. EBioMedicine. 2015;2(8):792-3.  https://doi.org/10.1016/j.ebiom.2015.06.028  PMID: 26425679 
  37. Perkins RB, Zisblatt L, Legler A, Trucks E, Hanchate A, Gorin SS. Effectiveness of a provider-focused intervention to improve HPV vaccination rates in boys and girls. Vaccine. 2015;33(9):1223-9.  https://doi.org/10.1016/j.vaccine.2014.11.021  PMID: 25448095 
/content/10.2807/1560-7917.ES.2016.21.47.30406
Loading

Data & Media loading...

Comment has been disabled for this content
Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error