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Abstract

Background

Paediatrician recommendations are known to influence parental vaccine decisions.

Aim

Our aim was to examine vaccination knowledge, attitudes and practices among paediatricians in Italy and identify factors associated with their confidence in addressing parental questions.

Methods

An electronic questionnaire survey was conducted from February to March 2016, among a sample of Italian paediatricians.

Results

The survey was completed by 903 paediatricians (mean age: 56 years). Of 885 who responded to the specific question, 843 (95.3%) were completely favourable to vaccinations. Sixty-six per cent (570/862) felt sufficiently knowledgeable about vaccinations and vaccine-preventable diseases to confidently discuss them with parents. Paediatricians who were male, who were 55 years or older, who had participated in training courses in the last 5 years, who reported that taking courses and reading the scientific literature had contributed to their knowledge, or who had implemented vaccination promotion activities, felt more knowledgeable than other paediatricians. When asked to rate their level of agreement with statements about vaccine safety and effectiveness, only 8.9% (80/903) responded fully as expected. One third (294/878) did not systematically verify that their patients are up to date with the immunisation schedule. Only 5.4% (48/892) correctly identified all true and false contraindications.

Conclusions

The majority of paediatricians in Italy are favourable to vaccination but gaps were identified between their overall positive attitudes and their knowledge, beliefs and practices. Targeted interventions are needed aimed at increasing paediatricians’ confidence in addressing parents’ concerns, strengthening trust towards health authorities and improving systems barriers.

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/content/10.2807/1560-7917.ES.2019.24.6.1800275
2019-02-07
2019-02-18
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.6.1800275
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References

  1. World Health Organization Strategic Advisory Group of Experts Vaccine Hesitancy Working Group. Report of the SAGE working group on vaccine hesitancy. Geneva: WHO; 2014. Available from: https://www.who.int/immunization/sage/meetings/2014/october/SAGE_working_group_revised_report_vaccine_hesitancy.pdf?ua=1
  2. Giambi C, Fabiani M, D’Ancona F, Ferrara L, Fiacchini D, Gallo T, et al. Parental vaccine hesitancy in Italy - Results from a national survey. Vaccine. 2018;36(6):779-87.  https://doi.org/10.1016/j.vaccine.2017.12.074  PMID: 29325822 
  3. Marti M, de Cola M, MacDonald NE, Dumolard L, Duclos P. Assessments of global drivers of vaccine hesitancy in 2014-Looking beyond safety concerns. PLoS One. 2017;12(3):e0172310.  https://doi.org/10.1371/journal.pone.0172310  PMID: 28249006 
  4. Williams SE. What are the factors that contribute to parental vaccine-hesitancy and what can we do about it? Hum Vaccin Immunother. 2014;10(9):2584-96.  https://doi.org/10.4161/hv.28596  PMID: 25483505 
  5. European Centre for Disease Prevention and Control (ECDC). Vaccine hesitancy among healthcare workers and their patients in Europe – A qualitative study. Stockholm: ECDC; 2015. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/vaccine-hesitancy-among-healthcare-workers.pdf
  6. Paterson P, Meurice F, Stanberry LR, Glismann S, Rosenthal SL, Larson HJ. Vaccine hesitancy and healthcare providers. Vaccine. 2016;34(52):6700-6.  https://doi.org/10.1016/j.vaccine.2016.10.042  PMID: 27810314 
  7. Karafillakis E, Dinca I, Apfel F, Cecconi S, Wűrz A, Takacs J, et al. Vaccine hesitancy among healthcare workers in Europe: A qualitative study. Vaccine. 2016;34(41):5013-20.  https://doi.org/10.1016/j.vaccine.2016.08.029  PMID: 27576074 
  8. 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 
  9. Shibli R, Shemer R, Lerner-Geva L, Rishpon S. Knowledge and recommendation regarding routine childhood vaccinations among pediatric healthcare providers in Israel. Vaccine. 2017;35(4):633-8.  https://doi.org/10.1016/j.vaccine.2016.12.005  PMID: 28043737 
  10. Schuler M, Schaedelin S, Aebi C, Berger C, Crisinel PA, Diana A, et al. Attitudes of Swiss health care providers toward childhood immunizations. Pediatr Infect Dis J. 2017;36(6):e167-74.  https://doi.org/10.1097/INF.0000000000001522  PMID: 28030524 
  11. European Centre for Disease Prevention and Control (ECDC). Risk of measles transmission in the EU/EEA. Stockholm: ECDC; 2018. Available from: https://ecdc.europa.eu/sites/portal/files/documents/Measles-rapid-risk-assessment-European-Union-countries.pdf
  12. Filia A, Bella A, Del Manso M, Baggieri M, Magurano F, Rota MC. Ongoing outbreak with well over 4,000 measles cases in Italy from January to end August 2017 - what is making elimination so difficult? Euro Surveill. 2017;22(37):30614.  https://doi.org/10.2807/1560-7917.ES.2017.22.37.30614  PMID: 28933342 
  13. Salmon DA, Pan WKY, Omer SB, Navar AM, Orenstein W, Marcuse EK, et al. Vaccine knowledge and practices of primary care providers of exempt vs. vaccinated children. Hum Vaccin. 2008;4(4):286-91.  https://doi.org/10.4161/hv.4.4.5752  PMID: 18424918 
  14. Larson HJ, Jarrett C, Schulz WS, Chaudhuri M, Zhou Y, Dube E, et al. Measuring vaccine hesitancy: The development of a survey tool. Vaccine. 2015;33(34):4165-75.  https://doi.org/10.1016/j.vaccine.2015.04.037  PMID: 25896384 
  15. Salmon DA, Moulton LH, Omer SB, Chace LM, Klassen A, Talebian P, et al. Knowledge, attitudes, and beliefs of school nurses and personnel and associations with nonmedical immunization exemptions. Pediatrics. 2004;113(6):e552-9.  https://doi.org/10.1542/peds.113.6.e552  PMID: 15173536 
  16. Office of Statistics. Annuario Statistico del Servizio Sanitario Nazionale –Anno 2013. [Annual statistical report of the Italian National Healthcare system 2013]. Rome: Ministero della Salute; 2016. Italian. Available from: http://www.salute.gov.it/imgs/C_17_pubblicazioni_2536_allegato.pdf
  17. van der Linden S. Why doctors should convey the medical consensus on vaccine safety. Evid Based Med. 2016;21(3):119.  https://doi.org/10.1136/ebmed-2016-110435  PMID: 27102008 
  18. van der Linden SL, Clarke CE, Maibach EW. Highlighting consensus among medical scientists increases public support for vaccines: evidence from a randomized experiment. BMC Public Health. 2015;15(1):1207.  https://doi.org/10.1186/s12889-015-2541-4  PMID: 26635296 
  19. 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 
  20. Verger P, Collange F, Fressard L, Bocquier A, Gautier A, Pulcini C, et al. Prevalence and correlates of vaccine hesitancy among general practitioners: a cross-sectional telephone survey in France, April to July 2014. Euro Surveill. 2016;21(47):30406.  https://doi.org/10.2807/1560-7917.ES.2016.21.47.30406  PMID: 27918262 
  21. Le Maréchal M, Fressard L, Raude J, Verger P, Pulcini C. General practitioners and vaccination of children presenting with a benign infection. Med Mal Infect. 2018;48(1):44-52.  https://doi.org/10.1016/j.medmal.2017.09.018  PMID: 29113691 
  22. Kernéis S, Jacquet C, Bannay A, May T, Launay O, Verger P, et al. Vaccine education of medical students: a nationwide cross-sectional survey. Am J Prev Med. 2017;53(3):e97-104.  https://doi.org/10.1016/j.amepre.2017.01.014  PMID: 28237636 
  23. Campbell H, Edwards A, Letley L, Bedford H, Ramsay M, Yarwood J. Changing attitudes to childhood immunisation in English parents. Vaccine. 2017;35(22):2979-85.  https://doi.org/10.1016/j.vaccine.2017.03.089  PMID: 28442229 
  24. Suryadevara M, Handel A, Bonville CA, Cibula DA, Domachowske JB. Pediatric provider vaccine hesitancy: An under-recognized obstacle to immunizing children. Vaccine. 2015;33(48):6629-34.  https://doi.org/10.1016/j.vaccine.2015.10.096  PMID: 26529071 
  25. Dubé E, Gagnon D, Zhou Z, Deceuninck G. Parental vaccine hesitancy in Quebec (Canada). PLoS Curr. 2016;8:9e239605f4d320c6ad27ce2aea5aaad2.
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