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Mastrovito B, Lardon A, Dubromel A, Nave V, Beny K, Dussart C. Understanding the gap between guidelines and influenza vaccination coverage in people with diabetes: a scoping review. Front Public Health 2024; 12:1360556. [PMID: 38706547 PMCID: PMC11066301 DOI: 10.3389/fpubh.2024.1360556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/09/2024] [Indexed: 05/07/2024] Open
Abstract
Background Diabetes affects millions of people worldwide, making them more vulnerable to infections, including seasonal influenza. It is therefore particularly important for those suffering from diabetes to be vaccinated against influenza each year. However, influenza vaccination coverage remains low in this population. This review primarily aims to identify the determinants of influenza vaccination in people with diabetes (T1D or T2D). Secondly, it aims to assess main recommendations for influenza vaccination, vaccine effectiveness, vaccination coverage, and how education and pharmacists can encourage uptake of the vaccine in the diabetic population. Methods A scoping review was conducted in January 2022 to systematically review evidence on influenza vaccination in people with diabetes using data from PubMed, Science Direct, and EM Premium with terms such as "Diabetes mellitus," "Immunization Programs," "Vaccination," and "Influenza Vaccines." Quality assessment and data extraction were independently conducted by two authors. Disagreements between the authors were resolved through discussion and consensus, and if necessary, by consulting a third author. Results Of the 333 records identified, 55 studies met the eligibility criteria for inclusion in this review. Influenza vaccination was recommended for people ≥6 months. Despite effectiveness evidence showing a reduction in mortality and hospitalizations in people with diabetes vaccinated vs. non-vaccinated ones, very few studies reported a coverage rate ≥ 75%, which is WHO's target objective. Determinants such as advanced age, presence of comorbidities and healthcare givers' advice were associated with increased vaccination uptake. On the contrary, fear of adverse reactions and concerns about vaccine effectiveness were significant barriers. Finally, education and pharmacists' intervention played a key role in promoting vaccination and increasing vaccination uptake. Conclusion Influenza vaccination coverage in people with diabetes remains low despite recommendations and evidence on vaccine effectiveness. Motivators and barriers as well as several socio-demographic and clinical factors have been identified to explain this trend. Efforts are now needed to increase the number of diabetics vaccinated against influenza, mainly through education and the involvement of healthcare givers.
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Affiliation(s)
- Brice Mastrovito
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Alexia Lardon
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Amelie Dubromel
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Viviane Nave
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Karen Beny
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
| | - Claude Dussart
- Hospices Civils de Lyon, Pharmacie et Stérilisation Centrales, Pharmacie centrale, Saint-Genis-Laval, France
- EA 4129 P2S Parcours Santé Systémique, Claude Bernard University Lyon 1, Lyon, France
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Kyakuwa N, Kimbugwe G, Nakanjako F, Kalute H, Mpooya S, Atuhairwe C, Perez L, Kikaire B. High uptake of COVID-19 vaccines among healthcare workers in urban Uganda. PLoS One 2024; 19:e0277072. [PMID: 38626070 PMCID: PMC11020364 DOI: 10.1371/journal.pone.0277072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/07/2023] [Indexed: 04/18/2024] Open
Abstract
OBJECTIVES The aim of the study was to describe the facilitators, barriers to and level of uptake of COVID-19 vaccines among healthcare workers in primary healthcare facilities in an urban setting in Uganda. MATERIALS AND METHODS We conducted a cross-sectional study among HCWs in private and public health facilities in Entebbe municipality between July 2021 and August 2021. Data was collected using a structured questionnaire that was shared, via an online link, to consented participants. Uptake of the vaccines among healthcare workers was analysed as proportions, and logistic regression was used to analyse barriers and facilitators to uptake of COVID-19 vaccines. RESULTS The study enrolled 360 participants, with 61.7% (n = 222) females. A total of 236 (65.6%) healthcare workers had received at least one dose of COVID-19 vaccine, with higher uptake among females 64% (n = 151). Age above 40 years (OR 2.16), working in a government healthcare facility (OR 3.12), participating in COVID-19 vaccine related activities (OR 4.62), and having tested for SARS-COV-2 (OR 3.05) increased the odds of having been vaccinated. Working in small roadside clinics reduced the odds of being vaccinated by almost 70%, while HCWs in government health services were 3.1 times more likely to have been vaccinated. History of having cared for a COVID-19 patient and having a positive SARS-COV-2 test result did not influence the uptake of the vaccines in the study population. CONCLUSION Vaccine uptake among HCWs was close to the World Health Organisation (WHO) recommended uptake of 70% by mid-2022.
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Affiliation(s)
| | | | | | - Hamza Kalute
- Uganda Virus Research Institute, Entebbe, Uganda
| | - Simon Mpooya
- Uganda Virus Research Institute, Entebbe, Uganda
| | | | | | - Bernard Kikaire
- Makerere University College of Health Sciences, Kampala, Uganda
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3
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Dimitrova V, Stoitsova S, Rangelov V, Raycheva R, Martinova M, Nenova G, Iakimova M, Georgieva I, Georgiev I, Krumova S, Minkova A, Vladimirova N, Nikolaeva-Glomb L. High vaccine confidence and strong approval of the mandatory immunization schedule among Bulgarian general practitioners in 2022. Hum Vaccin Immunother 2023; 19:2265640. [PMID: 37846744 PMCID: PMC10583620 DOI: 10.1080/21645515.2023.2265640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023] Open
Abstract
In a context of recently decreasing childhood immunization coverage and low uptake of COVID-19 vaccines in Bulgaria, this study measures vaccine hesitancy among general practitioners (GPs) in the country, as they are central to forming patients' attitudes. In 2022, a face-to-face survey was conducted through a simple random sample from an exhaustive national database of Bulgarian GPs. This study measured attitudes on vaccine importance, safety, and effectiveness, and attitudes toward the Bulgarian immunization schedule. Information was collected on demographic and GP practice characteristics and possible predictors of vaccine confidence in order to test for associations with attitudes toward immunization. GP attitudes toward vaccines and the immunization schedule in Bulgaria were generally positive. Among 358 respondents, 351 (98%,95%CI96-99%) strongly agreed/agreed that vaccines are important, 352 (98%,95%CI96-99%) that vaccines are effective, and 341 (95%,95%CI93-97%) that vaccines are safe. 347 respondents (97%,95%CI95-98%) affirmed that "it's good that vaccines from the children's immunization schedule are mandatory", and 331 (92%,95%CI89-95%) agreed with the statement "Bulgaria's childhood immunization has my approval". Trust in information from official institutions was among the strongest predictors of vaccine confidence. Respondents' vaccine confidence levels are within the ranges reported by GPs in other European countries and above those reported within the general Bulgarian population. GPs' vaccine confidence is highly associated with trust in official institutions. It is important to maintain trust in official institutions and to support GPs in communicating vaccine knowledge with patients so that vaccine hesitancy in the general population is countered.
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Affiliation(s)
- Veronika Dimitrova
- Department of Sociology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Savina Stoitsova
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Vanya Rangelov
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
- Department of Epidemiology and Disaster Medicine, Medical University Plovdiv, Plovdiv, Bulgaria
| | - Ralitsa Raycheva
- Department of Social Medicine and Public Health, Medical University Plovdiv, Plovdiv, Bulgaria
| | - Maria Martinova
- Communities and Identities Department, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Gergana Nenova
- Department of Sociology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Milena Iakimova
- Department of Sociology, Sofia University “St. Kliment Ohridski”, Sofia, Bulgaria
| | - Irina Georgieva
- Department of Virology, National Center for Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ivo Georgiev
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Stefka Krumova
- Department of Virology, National Center for Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Antoaneta Minkova
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Nadezhda Vladimirova
- Department of Epidemiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
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Kaur M, Coppeta L, Olesen OF. Vaccine Hesitancy among Healthcare Workers in Europe: A Systematic Review. Vaccines (Basel) 2023; 11:1657. [PMID: 38005989 PMCID: PMC10675787 DOI: 10.3390/vaccines11111657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
This study analyzes vaccine hesitancy (VH) among healthcare workers (HCWs) in 15 European countries. We have undertaken a systematic review by synthesizing data from 46 articles (between 2015 and 2022) encompassing 55,612 subjects. Despite the heterogeneity of the methods in the various studies, we found that physicians had consistently higher vaccination rates than nurses across different countries and different vaccines. Physicians' average vaccination rate was 79% across a selection of vaccines, while that of nurses was 62%. Concerns regarding vaccine safety, information gaps, and the responsibility of healthcare authorities in managing VH are highlighted by qualitative insights. This research contributes to our comprehension of the ways in which VH among HCWs is impacted by healthcare roles, vaccine types, and regional disparities. The insights gleaned from this analysis can serve as a guide for targeted interventions aimed at increasing vaccine acceptance and coverage in Europe, ultimately strengthening public health.
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Affiliation(s)
- Mandeep Kaur
- European Vaccine Initiative, Universitätsklinikum Heidelberg (Heidelberg University Hospital), Voßstraße 2, 69115 Heidelberg, Germany;
| | - Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Ole F. Olesen
- European Vaccine Initiative, Universitätsklinikum Heidelberg (Heidelberg University Hospital), Voßstraße 2, 69115 Heidelberg, Germany;
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Dimitrova V, Stoitsova S, Nenova G, Martinova M, Yakimova M, Rangelova V, Georgieva I, Georgiev I, Krumova S, Minkova A, Vladimirova N, Nikolaeva-Glomb L. Bulgarian General Practitioners' Communication Styles about Child Vaccinations, Mainly Focused on Parental Decision Making in the Context of a Mandatory Immunization Schedule. Healthcare (Basel) 2023; 11:2566. [PMID: 37761763 PMCID: PMC10531209 DOI: 10.3390/healthcare11182566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
The communication practices of general practitioners in relation with vaccines have not been a topic of wide scientific interest. In this article, we outline them in the context of Bulgaria. A representative, cross-sectional, quantitative, face-to-face survey was conducted among 358 Bulgarian general practitioners in 2022 using simple random sampling. We conducted an exploratory factor analysis using questions about the role of the GPs, which measure models of communication. Based on the factor analysis, we distinguished four communication styles. They were called: active communicator, restrictive communicator, informing communicator, and strained communicator. One-way ANOVA and the T-test were carried out to explore the connections between factor scores (communication styles) and other variables. One of the most important results in the study was that the informing physician (emphasizing the choice of the parents) was the most common model in Bulgaria. This is somewhat contradictory, because of the mandatory status of most vaccines. We found connections between the communication styles and other variables-such as the type of settlement, having a hesitant parent in the practice, recommendations of non-mandatory vaccines, and experience with vaccine-preventable diseases. On the basis of the factor analysis and analysis of relationships with other variables, we reached the conclusion that in Bulgaria, hesitant parents are not sufficiently involved in active, effective communication about vaccines by GPs.
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Affiliation(s)
- Veronika Dimitrova
- Department of Sociology, Sofia University, 1000 Sofia, Bulgaria; (G.N.); (M.Y.)
| | - Savina Stoitsova
- Department of Epidemiology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (S.S.); (I.G.); (A.M.); (N.V.)
| | - Gergana Nenova
- Department of Sociology, Sofia University, 1000 Sofia, Bulgaria; (G.N.); (M.Y.)
| | - Maria Martinova
- Communities and Identities Department, Institute of Sociology and Philosophy at the Bulgarian Academy of Sciences, 1000 Sofia, Bulgaria;
| | - Milena Yakimova
- Department of Sociology, Sofia University, 1000 Sofia, Bulgaria; (G.N.); (M.Y.)
| | - Vanya Rangelova
- Department of Epidemiology and Disaster Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria;
| | - Irina Georgieva
- Department of Virology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.G.); (S.K.); (L.N.-G.)
| | - Ivo Georgiev
- Department of Epidemiology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (S.S.); (I.G.); (A.M.); (N.V.)
| | - Stefka Krumova
- Department of Virology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.G.); (S.K.); (L.N.-G.)
| | - Antoaneta Minkova
- Department of Epidemiology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (S.S.); (I.G.); (A.M.); (N.V.)
| | - Nadezhda Vladimirova
- Department of Epidemiology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (S.S.); (I.G.); (A.M.); (N.V.)
| | - Lubomira Nikolaeva-Glomb
- Department of Virology, National Centre of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.G.); (S.K.); (L.N.-G.)
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6
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Jiang B, Cao Y, Qian J, Jiang M, Huang Q, Sun Y, Dai P, Yi H, Zhang R, Xu L, Zheng J, Yang W, Feng L. Healthcare Workers' Attitudes toward Influenza Vaccination: A Behaviour and Social Drivers Survey. Vaccines (Basel) 2023; 11:143. [PMID: 36679986 PMCID: PMC9863509 DOI: 10.3390/vaccines11010143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
This study aimed to understand the intention and correlation of receiving and recommending influenza vaccine (IV) among healthcare workers (HCWs) in China during the 2022/2023 season using the behavior and social drivers (BeSD) tools. A self-administered electronic survey collected 17,832 participants on a media platform. We investigated the willingness of IV and used multivariate logistic regression analysis to explore its associated factors. The average scores of the 3Cs’ model were compared by multiple comparisons. We also explored the factors that potentially correlated with recommendation willingness by partial regression. The willingness of IV was 74.89% among HCWs, and 82.58% of the participants were likely to recommend it to others during this season. Thinking and feeling was the strongest domain independently associated with willingness. All domains in BeSD were significantly different between the hesitancy and acceptance groups. Central factors in the 3Cs model were significantly different among groups (p < 0.01). HCWs’ willingness to IV recommendation was influenced by their ability to answer related questions (r = 0.187, p < 0.001) after controlling for their IV willingness and perceived risk. HCWs’ attitudes towards IV affect their vaccination and recommendation. The BeSD framework revealed the drivers during the decision-making process. Further study should classify the causes in detail to refine HCWs’ education.
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Affiliation(s)
- Binshan Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yanlin Cao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Jie Qian
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Mingyue Jiang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Qiangru Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yanxia Sun
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Peixi Dai
- Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Heya Yi
- Department of International Affairs, Chinese Preventive Medicine Association, Beijing 100062, China
| | - Run Zhang
- “Breath Circles” Network Platform, Beijing 100026, China
| | - Lili Xu
- Institute for Non-Communicable Disease Control and Prevention, Qinghai Provincial Center for Disease Control and Prevention, Xining 810007, China
| | - Jiandong Zheng
- Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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7
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Garrison A, Karlsson L, Fressard L, Fasce A, Rodrigues F, Schmid P, Taubert F, Holford D, Lewandowsky S, Nynäs P, Anderson EC, Gagneur A, Dubé E, Soveri A, Verger P. International adaptation and validation of the Pro-VC-Be: measuring the psychosocial determinants of vaccine confidence in healthcare professionals in European countries. Expert Rev Vaccines 2023; 22:726-737. [PMID: 37507356 DOI: 10.1080/14760584.2023.2242479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 06/29/2023] [Accepted: 07/26/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Healthcare professionals (HCPs) play an important role in vaccination; those with low confidence in vaccines are less likely to recommend them to their patients and to be vaccinated themselves. The study's purpose was to adapt and validate long- and short-form versions of the International Professionals' Vaccine Confidence and Behaviors (I-Pro-VC-Be) questionnaire to measure psychosocial determinants of HCPs' vaccine confidence and their associations with vaccination behaviors in European countries. RESEARCH DESIGN AND METHODS After the original French-language Pro-VC-Be was culturally adapted and translated, HCPs involved in vaccination (mainly GPs and pediatricians) across Germany, Finland, France, and Portugal completed a cross-sectional online survey in 2022. A 10-factor multigroup confirmatory factor analysis (MG-CFA) of the long-form (10 factors comprising 34 items) tested for measurement invariance across countries. Modified multiple Poisson regressions tested the criterion validity of both versions. RESULTS 2,748 HCPs participated. The 10-factor structure fit was acceptable to good everywhere. The final MG-CFA model confirmed strong factorial invariance and showed very good fit. The long- and short-form I-Pro-VC-Be had good criterion validity with vaccination behaviors. CONCLUSION This study validates the I-Pro-VC-Be among HCPs in four European countries; including long- and short-form tools for use in research and public health.
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Affiliation(s)
- Amanda Garrison
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Lisa Fressard
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Philipp Schmid
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Frederike Taubert
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Potsdam, Potsdam, Germany
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Peter Nynäs
- Faculty of Arts, Psychology and Theology, Abo Akademi University, Turku, Finland
| | | | - Arnaud Gagneur
- Department of Pediatrics, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Eve Dubé
- Département d'anthropologie, Faculté des Sciences Sociales, Université Laval, Laval, Canada
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Pierre Verger
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
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8
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Pavlovic D, Sahoo P, Larson HJ, Karafillakis E. Factors influencing healthcare professionals' confidence in vaccination in Europe: a literature review. Hum Vaccin Immunother 2022; 18:2041360. [PMID: 35290160 PMCID: PMC9009961 DOI: 10.1080/21645515.2022.2041360] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Health-care professionals (HCPs) have a fundamental role in vaccination, their own beliefs and attitudes affecting both their uptake and recommendation of vaccines. This literature review (n = 89) summarises evidence on HCPs’ perceptions of the risks and benefits of vaccination, trust, and perceptions of mandatory vaccination in Europe. HCPs across studies believed that vaccination is important to protect themselves and their patients. However, beliefs that some diseases such as influenza are less risky were reported by some HCPs as a reason for not getting vaccinated. Concerns about both short- and long-term side effects were identified among HCPs in most studies, such as those affecting the immune or neurological system. Mistrust toward health authorities and pharmaceutical industry was reported in some studies. The question of mandatory vaccination revealed mixed opinions, with some favoring self-determination and others viewing vaccination as a duty. This review highlights key factors influencing HCPs’ confidence in vaccination in Europe.
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Affiliation(s)
- D Pavlovic
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - P Sahoo
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - H J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.,Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Zagreb, Croatia
| | - E Karafillakis
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Zagreb, Croatia
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9
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Alasmari A, Larson HJ, Karafillakis E. A mixed methods study of health care professionals’ attitudes towards vaccination in 15 countries. Vaccine X 2022; 12:100219. [PMID: 36193232 PMCID: PMC9526144 DOI: 10.1016/j.jvacx.2022.100219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/26/2022] [Accepted: 09/19/2022] [Indexed: 11/19/2022] Open
Abstract
Background Health care professionals are widely considered to be the most trusted source of information on vaccine-related topics. However, several are reporting their own hesitancy around certain vaccines, influencing their intention to vaccinate themselves as well as influencing their recommendations to their patients and target population. Methods A mixed-methods approach was used including an online survey (n = 1,504) in 15 countries which aimed to determine drivers of HCPs vaccine confidence and examine how these drivers vary across nations. Thirty in-depth semi-structured interviews were conducted with 10 HCPs in a subset of three countries (France, Greece and Hungry) to explore barriers to HCPs vaccine uptake and their role in addressing vaccine hesitancy among patients. Findings. The survey’s regression analysis identified that nurses/midwives and HCPs from Hungary, Italy, Romania and Switzerland were less confident in the safety, importance or effectiveness of vaccines in general. Morocco (35%), Turkey (53%) and Greece (69%) reported the lowest influenza vaccination coverage among HCPs. Morocco also reported the lowest rates of HCPs who were “highly likely” to recommend MMR vaccine (34%), HPV vaccine (31%) and Covid-19 vaccines (29%). More than third of HCPs reported a lack of trust in health authorities and in the information they provide. Thematic analysis revealed that concerns over the risk of side-effects associated with vaccines, preference for natural immunity, whether it was necessary to be vaccinated against influenza every year, not having any chronic disease risk factors, and vaccines mandates as the key barriers to HCPs vaccination against influenza and Covid-19. Conclusion HCPs have an important role in vaccination and their confidence in vaccination and health authorities must be improved as this may affect their uptake of vaccines and influence their recommendations to their patients. Investigating the impact of political, socio-economic and cultural contexts on concerns about vaccination among HCPs is also necessary.
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Affiliation(s)
- Abrar Alasmari
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Corresponding author.
| | - Heidi J. Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Health Metrics Sciences, University of Washington, Seattle, United States
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Emilie Karafillakis
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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10
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Bussink-Voorend D, Hautvast JLA, Vandeberg L, Visser O, Hulscher MEJL. A systematic literature review to clarify the concept of vaccine hesitancy. Nat Hum Behav 2022; 6:1634-1648. [PMID: 35995837 DOI: 10.1038/s41562-022-01431-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 07/13/2022] [Indexed: 11/25/2022]
Abstract
Vaccine hesitancy (VH) is considered a top-10 global health threat. The concept of VH has been described and applied inconsistently. This systematic review aims to clarify VH by analysing how it is operationalized. We searched PubMed, Embase and PsycINFO databases on 14 January 2022. We selected 422 studies containing operationalizations of VH for inclusion. One limitation is that studies of lower quality were not excluded. Our qualitative analysis reveals that VH is conceptualized as involving (1) cognitions or affect, (2) behaviour and (3) decision making. A wide variety of methods have been used to measure VH. Our findings indicate the varied and confusing use of the term VH, leading to an impracticable concept. We propose that VH should be defined as a state of indecisiveness regarding a vaccination decision.
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Affiliation(s)
- Daphne Bussink-Voorend
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands.
| | - Jeannine L A Hautvast
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands
| | - Lisa Vandeberg
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Olga Visser
- Radboud University Medical Center, Radboud Institute for Health Sciences, Primary and Community Care, Nijmegen, the Netherlands
| | - Marlies E J L Hulscher
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
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11
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Amour S, Bénet T, Regis C, Robert O, Fontana L, Lina B, Pozzetto B, Berthelot P, Vanhems P. Effect of influenza vaccination among healthcare workers on hospital-acquired influenza in short-stay hospitalized patients: A multicenter pilot study in France. Infect Control Hosp Epidemiol 2022; 43:1828-32. [PMID: 35382916 DOI: 10.1017/ice.2022.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Exposure to infected healthcare workers (HCWs) is a source of hospital-acquired (HA) influenza. We estimated the risk of HA influenza for hospitalized patients by rate of influenza vaccine coverage (IVC) of HCWs. METHODS A case-case negative control study nested in a prospective cohort was conducted in 2 French university hospitals during 2 influenza seasons. Each inpatient with influenza-like illness (ILI) provided a nasal swab sample that was systematically analyzed for influenza virus by polymerase chain reaction (PCR) testing. An HA influenza case was a patient with a virological confirmation of influenza with onset of symptoms ≥72 hours after admission to the ward. The IVC rate of HCWs in each participating ward was calculated from the data provided by the occupational health departments. A mixed-effect logistic regression was performed with adjustments on patient sex, age, the presence of a potential source of influenza on the ward in the 5 days prior to the start of the ILI, type of ward and influenza season. RESULTS The overall HA influenza attack rate was 1.9 per 1,000 hospitalized patients. In total, 24 confirmed HA influenza cases and 141 controls were included. The crude odds ratio (OR) of HA influenza decreased from 0.52 (95% confidence interval [CI], 0.21-1.29) to 0.14 (95% CI, 0.03-0.63) when the IVC of HCWs increased from 20% to 40%. After adjustment, IVC ≥40% was associated with a risk reduction of HA influenza (aOR, 0.07; 95% CI, 0.01-0.78). CONCLUSIONS Considering a limited sample size, influenza vaccination of HCWs is highly suggestive of HA flu prevention among hospitalized patients.Trial Registration: clinicaltrials.gov identifier: NCT02198638.
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12
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Carrier H, Zaytseva A, Bocquier A, Villani P, Fortin M, Verger P. General practitioners' attitude towards cooperation with other health professionals in managing patients with multimorbidity and polypharmacy: A cross-sectional study. Eur J Gen Pract 2022; 28:109-117. [PMID: 35593116 PMCID: PMC9132456 DOI: 10.1080/13814788.2022.2044781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Cooperation between general practitioners (GPs) and other healthcare professionals appears to help reduce the risk of polypharmacy-related adverse events in patients with multimorbidity. Objectives To investigate GPs profiles according to their opinions and attitudes about interprofessional cooperation and to study the association between these profiles and GPs’ characteristics. Methods Between May and July 2016, we conducted a cross-sectional survey of a panel of French GPs about their management of patients with multimorbidity and polypharmacy, focussing on their opinions on the roles of healthcare professionals and interprofessional cooperation. We used agglomerative hierarchical cluster analysis to identify GPs profiles, then multivariable logistic regression models to study their associations with the characteristics of these doctors. Results 1183 GPs responded to the questionnaire. We identified four profiles of GPs according to their declared attitudes towards cooperation: GPs in the ‘very favourable’ profile (14%) were willing to cooperate with various health professionals, including the delegation of some prescribing tasks to pharmacists; GPs in the ‘moderately favourable’ profile (47%) had favourable views on the roles of health professionals, with the exception for this specific delegation of the task; GPs from the ‘selectively favourable’ profile (27%) tended to work only with doctors; GPs from the ‘non-cooperative’ profile (12%) did not seem to be interested in cooperation. Some profiles were associated with GPs’ ages or participation in continuing medical education. Conclusion Our study highlights disparities between GPs regarding cooperation with other professionals caring for their patients and suggests ways to improve cooperation.
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Affiliation(s)
- Hélène Carrier
- Department of General Practice, Aix Marseille University, Marseille, France.,ORS Paca, Regional Health Observatory, Provence- Alpes-Côte d'Azur, Marseille, France
| | - Anna Zaytseva
- ORS Paca, Regional Health Observatory, Provence- Alpes-Côte d'Azur, Marseille, France.,Aix Marseille University, CNRS (French National Centre for Scientific Research), EHESS (School of Advanced Studies in the Social Sciences), Centrale Marseille, AMSE (Aix-Marseille School of Economics), France
| | - Aurélie Bocquier
- ORS Paca, Regional Health Observatory, Provence- Alpes-Côte d'Azur, Marseille, France
| | - Patrick Villani
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique des Hôpitaux de Marseille (AP-HM), Marseille, France.,Anthropology Bio-Cultural, Law and Ethics (ADES), French Blood Agency (EFS), National Center for Scientific Research (CNRS), Aix Marseille University, Marseille, France
| | - Martin Fortin
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada.,Centre Universitaire de Santé et de Services Sociaux du Saguenay-Lac St-Jean, Chicoutimi, Quebec, Canada
| | - Pierre Verger
- ORS Paca, Regional Health Observatory, Provence- Alpes-Côte d'Azur, Marseille, France
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13
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Wiedermann W, Ausserhofer D, Vögele A, Becker U, Piccoliori G, Wiedermann CJ, Engl A. Awareness and use of home remedies in Italy’s alps: a population-based cross-sectional telephone survey. BMC Complement Med Ther 2022; 22:292. [PMID: 36369002 PMCID: PMC9650663 DOI: 10.1186/s12906-022-03781-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Belief in complementary and alternative medicine practices is related to reduced preparedness for vaccination. This study aimed to assess home remedy awareness and use in South Tyrol, where vaccination rates in the coronavirus pandemic were lowest in Italy and differed between German- and Italian-speaking inhabitants. Methods A population-based survey was conducted in 2014 and analyzed using descriptive statistics, multiple logistic regression, and latent class analysis. Results Of the representative sample of 504 survey respondents, 357 (70.8%) participants (43.0% male; primary language German, 76.5%) reported to use home remedies. Most commonly reported home remedies were teas (48.2%), plants (21.0%), and compresses (19.5%). Participants from rural regions were less likely (odds ratio 0.35, 95% confidence interval 0.19–0.67), while female (2.62, 1.69–4.10) and German-speaking participants (5.52, 2.91–9.88) were more likely to use home remedies. Latent classes of home remedies were “alcoholic home remedies” (21.4%) and “non-alcohol-containing home remedies” (78.6%). Compared to the “non-alcohol-containing home remedies” class, members of the “alcoholic home remedies” class were more likely to live in an urban region, to be male and German speakers. Conclusion In addition to residence and sex, language group membership associates with awareness and use of home remedies. Home remedies likely contribute to socio-cultural differences between the language groups in the Italian Alps. If the observed associations explain the lower vaccination rates in South Tyrol among German speakers requires further study. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-022-03781-0.
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Prieto-Campo Á, García-Álvarez RM, López-Durán A, Roque F, Herdeiro MT, Figueiras A, Zapata-Cachafeiro M. Understanding Primary Care Physician Vaccination Behaviour: A Systematic Review. Int J Environ Res Public Health 2022; 19:13872. [PMID: 36360750 PMCID: PMC9654811 DOI: 10.3390/ijerph192113872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Vaccine hesitancy decreases adult vaccination coverage and has been recognized by WHO as a major health threat. Primary care physicians (PCP) play a key role in vaccination by giving vaccine counselling to their patients. The aim of this systematic review is to identify the knowledge, beliefs, attitudes and barriers (KBAB) associated with own vaccination and patient recommendation in primary care physicians. METHODS MEDLINE/PubMed, EMBASE and Cochrane Library databases were used to search and identify relevant studies based on their title and abstract. In the next step, the full text of each previously selected article was read for eligibility. Articles were selected by two independent reviewers and data extraction was performed using tables. The following information was extracted: methodological characteristics, demographic factors, professional characteristics, and intrinsic or extrinsic factors influencing vaccination or recommendation. RESULTS Our search yielded 41 eligible papers, data-sources, previous practices, belief in the effectiveness or safety of the vaccine, perceived risk, and trust in health authorities were all shown to be related to own vaccination and patient recommendation. CONCLUSION Internet is the main source of information for PCP related to vaccine hesitancy. It is therefore essential to increase the presence and access to pro-vaccination content in this area. In addition, involving PCP in the establishment of vaccination recommendations could improve their credibility in the institutions. On the other hand, training in communication skills and establishing reminder systems could reflect higher vaccination coverage among their patients.
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Affiliation(s)
- Ángela Prieto-Campo
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786 Santiago de Compostela, Spain
| | - Rosa María García-Álvarez
- Department of Preventive Medicine and Public Health, Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - Ana López-Durán
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, 15786 Santiago de Compostela, Spain
| | - Fátima Roque
- Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), Avenida Dr. Francisco Sá Carneiro, No. 50, 6300-559 Guarda, Portugal
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), Av. Infante D. Henrique, 6200-506 Covilhã, Portugal
- Escola Superior de Saúde, Instituto Politécnico da Guarda Rua da Cadeia, 6300-035 Guarda, Portugal
| | - Maria Teresa Herdeiro
- Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786 Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER of Epidemiology and Public Health, CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), 15786 Santiago de Compostela, Spain
| | - Maruxa Zapata-Cachafeiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15786 Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER of Epidemiology and Public Health, CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), 15786 Santiago de Compostela, Spain
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15
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Garrison A, Fressard L, Karlsson L, Soveri A, Fasce A, Lewandowsky S, Schmid P, Gagneur A, Dubé E, Verger P. Measuring psychosocial determinants of vaccination behavior in healthcare professionals: validation of the Pro-VC-Be short-form questionnaire. Expert Rev Vaccines 2022; 21:1505-1514. [PMID: 35938710 DOI: 10.1080/14760584.2022.2108800] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Vaccine confidence among health care professionals (HCPs) is a key determinant of vaccination behaviors. We validate a short-form version of the 31-item Pro-VC-Be (Health Professionals Vaccine Confidence and Behaviors) questionnaire that measures HCPs' confidence in and commitment to vaccination. RESEARCH DESIGN AND METHODS A cross-sectional survey among 2,696 HCPs established a long-form tool to measure 10 dimensions of psychosocial determinants of vaccination behaviors. Confirmatory factor analysis (CFA) models tested the construct validity of 69,984 combinations of items in a 10-item short form tool. The criterion validity of this tool was tested with four behavioral and attitudinal outcomes using weighted modified Poisson regressions. An immunization resource score was constructed from summing the responses of the dimensions that can influence HCPs' pro-vaccination behaviors: vaccine confidence, proactive efficacy, and trust in authorities. RESULTS The short-form tool showed good construct validity in CFA analyses (RMSEA = 0.035 [0.024; 0.045]; CFI = 0.956; TLI = 0.918; SRMR 0.027) and comparable criterion validity to the long-form tool. The immunization resource score showed excellent criterion validity. CONCLUSIONS The Pro-VC-Be short-form showed good construct validity and criterion validity similar to the long-form and can therefore be used to measure determinants of vaccination behaviors among HCPs.
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Affiliation(s)
- Amanda Garrison
- Faculty of Medicine, ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Lisa Fressard
- Faculty of Medicine, ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK.,School of Psychological Science, University of Western Australia, Perth, Australia
| | - Philipp Schmid
- Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Arnaud Gagneur
- Department of Pediatrics, Centre de Recherche du CHUS, Sherbrooke, Quebec, Canada.,Département de Pédiatrie, Université de Sherbrooke-Campus de la Santé, Sherbrooke, Quebec, Canada
| | - Eve Dubé
- Department of Anthropology, Laval University, Quebec City, Quebec, Canada
| | - Pierre Verger
- Faculty of Medicine, ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
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16
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Wyplosz B, Fernandes J, Sultan A, Roche N, Roubille F, Loubet P, Fougère B, Moulin B, Duhot D, Vainchtock A, Raguideau F, Lortet-Tieulent J, Blanc E, Moïsi J, Goussiaume G. Pneumococcal and influenza vaccination coverage among at-risk adults: A 5-year French national observational study. Vaccine 2022; 40:4911-4921. [PMID: 35811205 DOI: 10.1016/j.vaccine.2022.06.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/24/2022] [Accepted: 06/26/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The risk of developing pneumococcal infections increases with certain chronic conditions and in immunocompromised patients. We aimed to monitor pneumococcal vaccination coverage in at-risk patients and to examine factors associated with pneumococcal vaccination in France. MATERIAL AND METHODS In this annual cross-sectional study, at-risk patients were extracted between 2014 and 2018 from the National Health Insurance's (NHI) General scheme's claims database with their vaccine reimbursements. Descriptive analyses and a logistic model were performed to assess the influence of healthcare use and medical and demographic factors on pneumococcal vaccination. RESULTS AND DISCUSSION In 2018, 4.5% of 4,045,021 at-risk adults were up to date with their pneumococcal vaccination. During the study period, the number of patients with chronic medical conditions (86% of 4,045,021) increased by 10.1%, but vaccination coverage decreased from 12.9% to 2.9%. The population with immunocompromised status (14% of 4,045,021) increased by 16.2% and vaccination coverage from 10.3% to 18.8%. Influenza vaccination coverage was much higher and stable (around 45.0%). Factors associated with pneumococcal vaccination were: immunocompromised status vs. having a chronic medical condition (odds ratio [OR] 4.72), influenza vaccination (OR 2.36-3.42), hepatitis B vaccination (OR 2.82), DTPolio vaccination (OR 1.52), ≥5 specialist physicians' visits (OR 1.17), and age above 74 (OR 1.12). Pneumococcal vaccine dispensing was extremely low (median of 9per GP,1per specialist over 9 years) despite frequent healthcare visits. CONCLUSION Pneumococcal and influenza vaccination coverage of adults at risk of pneumococcal disease fell well below public health expectations. Invitations for pneumococcal vaccination should be sent by the NHI to high-risk patients. Patient management protocols should include pneumococcal vaccination. Patients with multiple comorbidities are a high-priority population given the large potential health gains offered by pneumococcal vaccination. Commitment of both scientific societies and health authorities is urgently needed to increase vaccination coverage in at-risk populations.
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Affiliation(s)
- Benjamin Wyplosz
- AP-HP, Bicêtre University Hospital, Service de maladies infectieuses et tropicales, Centre de vaccinations internationales et de l'immunodéprimé, Le Kremlin-Bicêtre, France.
| | - Jérôme Fernandes
- Medical Information Department, Bayonne Hospital, Bayonne, France.
| | - Ariane Sultan
- PhyMedExp, University Montpellier, CNRS, INSERM, Endocrinology-Diabetology-Nutrition Department, University Montpellier, 34295 Montpellier, France.
| | | | | | - Paul Loubet
- Service des Maladies infectieuses et Tropicales, CHU de Nîmes - INSERM U1047 - Université de Montpellier, Nîmes (France).
| | - Bertrand Fougère
- Division of Geriatric Medicine, Tours University Hospital, Tours, France.
| | - Bruno Moulin
- Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France.
| | - Didier Duhot
- Société Française de Médecine Générale, Issy les Moulineaux, France.
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17
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Dong C, Yu Z, Quan X, Wei S, Wang J, Ma X. No Differences in Wound Healing and Scar Formation Were Observed in Patients With Different COVID-19 Vaccination Intervals. Front Public Health 2022; 10:883113. [PMID: 35719612 PMCID: PMC9198238 DOI: 10.3389/fpubh.2022.883113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/29/2022] [Indexed: 11/20/2022] Open
Abstract
Background Safety concerns are one of the most common reasons for COVID-19 vaccination refusal. In the field of plastic and reconstructive surgery, whether COVID-19 vaccination influences wound healing and scar formation is worthy of special attention. Methods In this study, patients with adult trauma with subcutaneous sutures placed by a single plastic surgeon in a single center were included. The vaccination interval was defined as the interval between the last dose of the COVID-19 vaccine and when surgical sutures were introduced. The patients were categorized by vaccination interval into three groups of <1, 1–3, and ≥3 months. Wound healing and scar formation were rated according to the Wound Assessment Inventory (WAI) and Patient and Observer Scar Assessment Scale (POSAS) in the groups at 7 days and after a 3-month follow-up. Results All total and individual scores of WAI and POSAS were not significantly different among the groups. Conclusion No differences in wound healing and scar formation were observed in patients with different COVID-19 vaccination intervals. Thus, it is not necessary to postpone COVID-19 vaccination, as the vaccine does not affect wound healing and scar formation in patients undergoing surgery. This study aimed to eliminate concerns and hesitancy in receiving the COVID-19 vaccine.
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Affiliation(s)
- Chen Dong
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhou Yu
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xin Quan
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Siming Wei
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jiayang Wang
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xianjie Ma
- Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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18
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Eisch E, Kuper P, Lindert L, Choi KA. Working Conditions of Occupational Physicians-A Scoping Review. Int J Environ Res Public Health 2022; 19:6222. [PMID: 35627762 DOI: 10.3390/ijerph19106222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/15/2022] [Accepted: 05/18/2022] [Indexed: 01/03/2023]
Abstract
Occupational physicians (OPs) offer a wide range of health support for employees and are confronted with varying job characteristics and demands. They monitor occupational health and safety and promote work(place)-related health measures and assessments. While helping employees to (re)gain a healthy status, their own job satisfaction as well as the investigation of their working conditions have earned limited research attention. Thus, this scoping review aims to summarize the current state of knowledge concerning OPs’ working conditions, i.e., work-related resources and stressors. PubMed, Web of Science and LIVIVO as well as grey literature were screened for relevant English or German articles until 10/2021. From a total of 1683 identified publications, we analyzed 24 full text articles that fulfilled all inclusion criteria. The overall study sample included 3486 male (54.6%), 2892 female (45.3%) and 5 diverse OPs, from which 1049 OPs worked in full-time (85.6%) and 177 in part-time (14.4%). The majority (72.4%) worked for the Occupational Health Service (OHS), 13% were self-employed, and 14.6% worked for a company/in-house service. The classification of stressors and resources was based on an inductively generated categorization scheme. We categorized 8 personal, relational and environmental resources and 10 stress factors. The main resources were support for personnel development and promotion, positive organizational policy, promoting work-life balance and other aspects of health. Key stressors were information deficits, organizational deficiency and uncertainty as well as socioeconomic influences and high professional obligations. The working conditions of OPs are still a topic with too little research attention. This scoping review reveals several starting points to maintain a healthy OP workforce and gives recommendations for action for the near future.
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Moirangthem S, Olivier C, Gagneux-Brunon A, Péllissier G, Abiteboul D, Bonmarin I, Rouveix E, Botelho-Nevers E, Mueller JE. Social conformism and confidence in systems as additional psychological antecedents of vaccination: a survey to explain intention for COVID-19 vaccination among healthcare and welfare sector workers, France, December 2020 to February 2021. Euro Surveill 2022; 27. [PMID: 35485271 PMCID: PMC9052769 DOI: 10.2807/1560-7917.es.2022.27.17.2100617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background The start of the COVID-19 vaccination campaign among French healthcare and welfare sector workers in January 2021 offered an opportunity to study psychological antecedents of vaccination in this group. Aim We explored whether knowledge and attitude items related to social conformism and confidence in systems contributed to explaining intention for COVID-19 vaccination. Methods We developed a knowledge and attitude questionnaire with 30 items related to five established and two hypothetical psychological antecedents of vaccination (KA-7C). The online questionnaire was distributed from 18 December 2020 to 1 February 2021 through chain-referral via professional networks, yielding a convenience sample. We used multivariable logistic regression to explore the associations of individual and grouped KA-7C items with COVID-19 vaccine intention. Results Among 5,234 participants, the vaccine intention model fit (pseudo R-squared values) increased slightly but significantly from 0.62 to 0.65 when adding social conformism and confidence in systems items. Intention to vaccinate was associated with the majority opinion among family and friends (OR: 11.57; 95% confidence interval (CI): 4.51–29.67) and a positive perception of employer’s encouragement to get vaccinated (vs negative; OR: 6.41; 95% CI: 3.36–12.22). The strongest association of a knowledge item was identifying the statement ‘Some stages of vaccine development (testing) have been skipped because of the epidemic emergency.’ as false (OR: 2.36; 95% CI: 1.73–3.22). Conclusion The results suggest that social conformism and confidence in systems are distinct antecedents of vaccination among healthcare and welfare workers, which should be taken into account in vaccine promotion.
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Affiliation(s)
| | - Cyril Olivier
- Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France
| | - Amandine Gagneux-Brunon
- CIC-1408, Vaccinologie, INSERM, CHU St Etienne, Saint-Étienne, France.,Chaire PreVacCI de l'Institut Presage, Université Jean Monnet Saint-Etienne, Saint-Étienne, France
| | - Gérard Péllissier
- Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France
| | - Dominique Abiteboul
- Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France
| | | | - Elisabeth Rouveix
- Université Versailles Saint Quentin en Yvelines, APHP, CHU Ambroise Paré, Versailles, France.,Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES), Paris, France
| | - Elisabeth Botelho-Nevers
- CIC-1408, Vaccinologie, INSERM, CHU St Etienne, Saint-Étienne, France.,Chaire PreVacCI de l'Institut Presage, Université Jean Monnet Saint-Etienne, Saint-Étienne, France
| | - Judith E Mueller
- Institut Pasteur, Paris, France.,EHESP French School of Public Health, Paris and Rennes, France
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20
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Huang D, Ganti L, Graham EW, Shah D, Aleksandrovskiy I, Al-Bassam M, Fraunfelter F, Falgiani M, Leon L, Lopez-Ortiz C. COVID-19 Vaccine Hesitancy Among Healthcare Providers. Health Psychol Res 2022; 10:34218. [PMID: 35774910 PMCID: PMC9239370 DOI: 10.52965/001c.34218] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 02/27/2022] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE Vaccine hesitancy among healthcare providers can compromise public confidence in vaccination during the ongoing COVID-19 global epidemic and increase susceptibility to life-threatening disease. We sought to investigate predictors of openness to vaccination among healthcare workers who choose not to be vaccinated against COVID-19 in order to explore potential solutions. METHODS Physicians, physician assistants, and nurses who chose not to be vaccinated were surveyed to decipher reasons for vaccine refusal and personal loss due to the virus along with demographic variables. Multivariate logistic regression analysis evaluated whether provider role, parenthood, and death of family or friends were associated with strong versus relative vaccine refusal. RESULTS The predominant reasons for vaccine hesitancy in this cohort of health care workers who had access to, but chose not to be vaccinated (n=500) were a concern for vaccine side effects (69.6%) and the belief that the vaccines are inadequately studied (61.6%). Being a physician, a parent, and having no experience of death in the family or friends had 2.64 times (95% CI: 1.65-4.23, p < 0.001), 1.72 times (95% CI: 1.05-2.81, p = 0.032), and 1.70 times (95% CI: 1.06-2.72, p = 0.028) the odds of strong vaccine refusal, respectively. Older age (35 and up) respondents were 1.83 times (95% CI: 1.24-2.68, p = 0.002) more likely to be open to vaccination.
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Affiliation(s)
- Derrick Huang
- Emergency Medicine, University of Central Florida College of Medicine
| | - Latha Ganti
- Emergency Medicine, University of Central Florida College of Medicine
| | | | - Dipal Shah
- Emergency Medicine, University of Central Florida College of Medicine
| | | | | | - Frank Fraunfelter
- Emergency Medicine, University of Central Florida College of Medicine
| | - Mike Falgiani
- Emergency Medicine, University of Central Florida College of Medicine
| | - Leoh Leon
- Emergency Medicine, University of Central Florida College of Medicine
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21
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Abstract
Background Over the last years, research interest in vaccine hesitancy has increased.
Studies usually focus on perceptions of parents and have largely neglected
the group of health care providers. However, doctors’ notions on
vaccination have a major impact on the decision-making process of their
patients. We were interested to understand the phenomenon of vaccine
hesitancy among physicians, with a particular focus on the measles vaccine.
Furthermore, we aimed to understand the underlying perceptions of measles
that may be associated with vaccine hesitant decisions. Methods In order to get an in-depth view, semi-structured interviews with physicians
were conducted. Doctors were eligible for the study if they articulated
vaccine hesitant views and/or demonstrated vaccine hesitancy in their
medical practice. Results We interviewed 12 physicians, of whom 11 had a medical practice with no
contract with the Austrian social insurance (‘Wahlarzt’) and
additional training in complementary and alternative medicine. We found
perceptions of immunology, health and illness that were discordant with
evidence-based medicine and closely related to alternative and complementary
medicine. All participants argued for a delayed administration of the
measles vaccine. We found a consistent inclination towards
‘individual vaccination’, which was explained as empowering
parents and to strengthen their decision-making competencies. Most
participants expressed doubts about the reliability of vaccine studies and
were concerned with possible long-term effects. Conclusions Paying closer attention to doctors’ concerns on vaccination might
help to design target-oriented interventions to specifically strengthen
vaccine confidence.
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Affiliation(s)
- Franziska Ecker
- Department of Social and Preventive Medicine, Center
for Public Health, Medical University of Vienna, Vienna, Austria
- Correspondence: Franziska Ecker, Department of Social and
Preventive Medicine, Center for Public Health, Medical University of Vienna,
Kinderspitalgasse 15, Vienna 1090, Austria, Tel: +43 660 46 76 46 9,
e-mail:
| | - Ruth Kutalek
- Department of Social and Preventive Medicine, Center
for Public Health, Medical University of Vienna, Vienna, Austria
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22
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Gobert C, Semaille P, Van der Schueren T, Verger P, Dauby N. Prevalence and Determinants of Vaccine Hesitancy and Vaccines Recommendation Discrepancies among General Practitioners in French-Speaking Parts of Belgium. Vaccines (Basel) 2021; 9:vaccines9070771. [PMID: 34358187 PMCID: PMC8310255 DOI: 10.3390/vaccines9070771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/01/2021] [Accepted: 07/06/2021] [Indexed: 12/11/2022] Open
Abstract
General practitioners (GPs) play a critical role in patient acceptance of vaccination. Vaccine hesitancy (VH) is a growing phenomenon in the general population but also affects GPs. Few data exist on VH among GPs. The objectives of this analysis of a population of GPs in the Belgian Wallonia-Brussels Federation (WBF) were to: (1) determine the prevalence and the features of VH, (2) identify the correlates, and (3) estimate the discrepancy in vaccination’s behaviors between the GPs’ children and the recommendations made to their patients. An online survey was carried out among the population of general practitioners practicing in the WBF between 7 January and 18 March 2020. A hierarchical cluster analysis was carried out based on various dimensions of vaccine hesitancy: perception of the risks and the usefulness of vaccines as well as vaccine recommendations for their patients. A total of 251 GPs answered the survey. The average percentage of moderate to high vaccine hesitancy was 50.6%. Three factors were independently associated with increased risk of vaccine hesitancy: an age <50 years old, having no children, and having no contact with selected vaccine-preventable disease (measles, complicated influenza, chronic hepatitis B (HBV), bacterial meningitis, or cervical cancer) in the past 5 years. VH was associated with controversies on vaccines’ safety. GPs who had vaccinated their children against six diseases (MMR, meningococcus C (MenC), HBV, and HPV) tended not to recommend the same vaccines to their patients. Among GPs with all children vaccinated against HBV, only 37.5% recommended catch-up HBV immunization to their patients. In this small cohort of GP, moderate to high VH was associated with controversies on vaccines’ safety and with specific personal characteristics (age <50, no children, and no recent experience with a serious VPD). As previously reported, GPs have different vaccine prescription attitude toward their patients and children. These findings should be confirmed in larger cohorts.
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Affiliation(s)
- Cathy Gobert
- Department of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), 1000 Bruxelles, Belgium;
| | - Pascal Semaille
- Department of General Medicine, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium;
| | | | - Pierre Verger
- Southeastern Health Regional Observatory (ORS PACA), 13005 Marseille, France;
| | - Nicolas Dauby
- Department of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), 1000 Bruxelles, Belgium;
- School of Public Health, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
- Institute for Medical Immunology, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
- Correspondence:
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23
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Lin C, Mullen J, Smith D, Kotarba M, Kaplan SJ, Tu P. Healthcare Providers' Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review. Vaccines (Basel) 2021; 9:vaccines9070713. [PMID: 34358132 PMCID: PMC8310254 DOI: 10.3390/vaccines9070713] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/09/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022] Open
Abstract
Despite vaccines' effectiveness in reducing the rate of preventable diseases, vaccine hesitancy has threatened public health and economies worldwide. Healthcare providers' (HCP) communications and behavior strongly influence patient receptivity and uptake. The goal of this review was to examine HCP vaccine perceptions, knowledge, and reservations and how these attitudes affect their recommendations and vaccination practices. Primary research studies published by 16 September 2020 were searched in PubMed, Web of Science, Embase, CINAHL, and PsycINFO. A 14-item scale was developed for survey study and risk of bias appraisal (SSRBA). In total, 96 papers from 34 countries were included, covering 17 vaccines (HPV and influenza vaccines the most studied). Recommendation was positively associated with provider knowledge and experience, beliefs about disease risk, and perceptions of vaccine safety, necessity, and efficacy. HCP vaccination attitudes and practices varied across specialties, vaccines, and countries; demographic impact was inconclusive. Barriers included anticipation of patient/parental concerns or refusal, lacking clear guidelines, time constraints, and cost. For HPV, vaccines were more often recommended to older, female adolescents and by physicians who discussed sexual health. HCPs are vital advocates for patients and the public, but studies indicated a prevalence of provider hesitancy pertaining to inadequate knowledge, low vaccine confidence, and suboptimal uptake themselves. Improving HCP knowledge and assuring their access to information they deem trustworthy are essential to supporting HCPs' role as "trusted messengers" to promote vaccine acceptance.
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Affiliation(s)
- Cheryl Lin
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Jewel Mullen
- Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Danielle Smith
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Michaela Kotarba
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Samantha J. Kaplan
- Medical Center Library and Archives, Duke University, Durham, NC 27710, USA;
| | - Pikuei Tu
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
- Correspondence:
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24
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Verger P, Dualé C, Lenzi N, Scronias D, Pulcini C, Launay O. Vaccine hesitancy among hospital staff physicians: A cross-sectional survey in France in 2019. Vaccine 2021; 39:4481-8. [PMID: 34210575 DOI: 10.1016/j.vaccine.2021.06.053] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 05/24/2021] [Accepted: 06/19/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Healthcare professionals, because they recommend vaccines to their patients, answer their questions, and vaccinate them, are the cornerstone of vaccination in France. They can nonetheless be affected by vaccine hesitancy (VH). AIMS We sought to study the opinions, practices, and perceptions of French hospital staff physicians (HSPs) toward vaccination and the prevalence and correlates of VH among them. METHODS We conducted a cross-sectional survey in 14 public hospitals in France from September 2018 to October 2019. HSPs completed a standardized questionnaire -most of the time face-to-face - about their vaccine-related attitudes and practices. Data were weighted for age and sex. An agglomerative hierarchical cluster analysis of the HSPs' perceptions and opinions toward vaccination allowed us to identify vaccine-hesitant HSPs, and multiple Poisson regression with robust standard errors let us study the factors associated with VH. RESULTS The study included 1,795 HSPs (participation rate: 86%). Almost all (93.7%) were strongly favorable to vaccination, even though 42.2% (95CI = 39.8-44.6) showed moderate VH. VH prevalence was lowest among infectious disease specialists (12.3%; 95CI = 6.7-21.3) and pediatricians (27.7%; 95CI = 21.4-35.2). Hesitant HSPs were less trustful of vaccination information sources and doubted the safety of vaccines more often than HSPs with almost no VH. Compared with non-hesitant HSPs, those with higher VH had less often taken a medical course about vaccination and were less likely to be vaccinated against seasonal influenza, to recommend vaccines to their patients and to try to convince vaccine-hesitant patients to be vaccinated. CONCLUSIONS Strong favorability to vaccination does not prevent VH, which was observed in most specialties. Interventions are required to help hesitant HSPs to adopt more proactive vaccination practices.
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25
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Abstract
An often-stated public health comment is that "vaccination is a victim of its own success." While the scientific and medical consensus on the benefits of vaccination is clear and unambiguous, an increasing number of people are perceiving vaccines as unsafe and unnecessary. The World Health Organization identified "the reluctance or refusal to vaccinate despite availability of vaccines" as one of the 10 threats to global health in 2019. The negative influence of anti-vaccination movements is often named as a cause of increasing vaccine resistance in the public. In this review, we give an overview of the current literature on the topic, beginning by agreeing on terminology and concepts before looking at potential causes, consequences, and impacts of resistance to vaccination.
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Affiliation(s)
- Ève Dubé
- Centre de Recherche du CHU de Québec, Université Laval, Québec G1V 4G2, Canada.,Institut National de Santé Publique du Québec, Québec G1E 7G9, Canada;
| | - Jeremy K Ward
- CERMES3, INSERM, CNRS, EHESS, Université de Paris, 94076 Villejuif, France; .,Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, VITROME, 13005 Marseille, France;
| | - Pierre Verger
- Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, VITROME, 13005 Marseille, France; .,Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 13005 Marseille, France
| | - Noni E MacDonald
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia B3K 6R8, Canada;
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26
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Verger P, Scronias D, Fradier Y, Meziani M, Ventelou B. Online study of health professionals about their vaccination attitudes and behavior in the COVID-19 era: addressing participation bias. Hum Vaccin Immunother 2021; 17:2934-2939. [PMID: 34047670 DOI: 10.1080/21645515.2021.1921523] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Online surveys of health professionals have become increasingly popular during the COVID-19 crisis because of their ease, speed of implementation, and low cost. This article leverages an online survey of general practitioners' (GPs') attitudes toward the soon-to-be-available COVID-19 vaccines, implemented in October-November 2020 (before the COVID-19 vaccines were authorized in France), to study the evolution of the distribution of their demographic and professional characteristics and opinions about these vaccines, as the survey fieldwork progressed, as reminders were sent out to encourage them to participate. Focusing on the analysis of the potential determinants of COVID-19 vaccine acceptance, we also tested if factors related to survey participation biased the association estimates. Our results show that online surveys of health professionals may be subject to significant selection bias that can have a significant impact on estimates of the prevalence of some of these professionals' behavioral, opinion, or attitude variables. Our results also highlight the effectiveness of reminder strategies in reaching hard-to-reach professionals and reducing these biases. Finally, they indicate that weighting for nonparticipation remains indispensable and that methods exist for testing (and correcting) selection biases.
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Affiliation(s)
- Pierre Verger
- ORS PACA (Southeastern Health Regional Observatory), Faculty of Medicine, Marseille, France
| | - Dimitri Scronias
- ORS PACA (Southeastern Health Regional Observatory), Faculty of Medicine, Marseille, France.,Centre D'investigation Clinique De l'Hôpital Cochin-Pasteur (CIC 1417), Assistance Publique Des Hôpitaux De Paris, Paris, France
| | | | | | - Bruno Ventelou
- ORS PACA (Southeastern Health Regional Observatory), Faculty of Medicine, Marseille, France.,Aix Marseille Université, CNRS, AMSE, Marseille, France
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27
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Verger P, Dualé C, Scronias D, Lenzi N, Pulcini C, Launay O. Attitudes of hospital physicians toward childhood mandatory vaccines in France: A cross-sectional survey. Hum Vaccin Immunother 2021; 18:1870393. [PMID: 33616464 PMCID: PMC8920152 DOI: 10.1080/21645515.2020.1870393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Due to a decades-long crisis of confidence in vaccination, in 2017 France extended the number of mandatory early childhood vaccines from 3 to 11. Aims To describe the opinions of hospital staff physicians (HSPs) regarding this measure, quantify the proportion who would have preferred measures based on education, and study the factors associated with the latter opinion. Methods Cross-sectional nationwide survey with a standardized questionnaire in 2018–2019 among HSPs in 14 French public hospitals. The factors associated with HSPs’ preference for education and persuasion over mandatory vaccination were analyzed with simple and multiple Poisson regressions. Results The analyses included 1,795 HSPs (participation rate of 86%). Among them, 84% considered the extension of mandatory childhood vaccination essential given the epidemiological context at the time; in a later question, 40% would have preferred education and persuasion. Multiple regressions showed that the latter tended to be younger and less trustful of sources of information about vaccination. They were more likely to think that information on the rationale behind the national vaccination policy lacked clarity and that the extension of mandatory vaccines was not essential, even in the current epidemiologic situation. Conclusion Although most HSPs agreed that the extension of mandatory childhood vaccines was essential, some were ambivalent about its coercive philosophy. Further research is necessary to better understand the reasons of this ambivalence. A fraction did not understand the French vaccination strategy well. Efforts to explain its details to HSPs and an overhaul of their initial training on vaccination are still needed.
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Affiliation(s)
- Pierre Verger
- Research Department, Southeastern Health Regional Observatory (Observatoire Régional De La Santé Paca), Marseille, France.,INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France
| | - Christian Dualé
- INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France.,Centre Hospitalo-universitaire, Clermont-Ferrand, Centre d'Investigation Clinique, INSERM, Clermont-Ferrand, France
| | - Dimitri Scronias
- Faculté de Médecine Paris Descartes, Université de Paris, Paris, France.,INSERM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Nezha Lenzi
- INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France.,Faculté de Médecine Paris Descartes, Université de Paris, Paris, France.,INSERM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Céline Pulcini
- PEMAC, équipe MICS, Université de Lorraine, Nancy, France.,Infectious Diseases Department, Université de Lorraine, CHRU-Nancy, Nancy, France
| | - Odile Launay
- INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France.,Faculté de Médecine Paris Descartes, Université de Paris, Paris, France.,INSERM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
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28
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Wilson RJI, Vergélys C, Ward J, Peretti-Watel P, Verger P. Vaccine hesitancy among general practitioners in Southern France and their reluctant trust in the health authorities. Int J Qual Stud Health Well-being 2021; 15:1757336. [PMID: 32400299 PMCID: PMC7269038 DOI: 10.1080/17482631.2020.1757336] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose: Vaccine hesitancy is common in France, including among general practitioners (GPs). We aimed to understand vaccine hesitant GPs’ views towards vaccines. Method: We conducted in-depth interviews that were thematically analysed. Result: We found that, facilitated by health scandals and vaccine controversies—that according to participants were not effectively handled by health authorities—the implicit contract existing between health authorities and GPs has been ruptured. This contract implies that health authorities support GPs in making vaccine recommendations by addressing GPs’ own concerns, providing them with adequate and up-to-date information and advice, and involving them in vaccine decision-making. In turn, GPs encourage vaccination to reach vaccine coverage targets. Conclusion: The rupture of this implicit contract has led to a breach in trust in the health authorities and the vaccines that they recommend.
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Affiliation(s)
- Rose Jane Isobel Wilson
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Chantal Vergélys
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Jeremy Ward
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,UMR 8236 (LIED), Université Paris Diderot, Paris, France
| | - Patrick Peretti-Watel
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Pierre Verger
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
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29
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Tomljenovic M, Petrovic G, Antoljak N, Hansen L. Vaccination attitudes, beliefs and behaviours among primary health care workers in northern Croatia. Vaccine 2020; 39:738-745. [PMID: 33386176 DOI: 10.1016/j.vaccine.2020.11.049] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 11/14/2020] [Accepted: 11/17/2020] [Indexed: 01/22/2023]
Abstract
Primary health care workers (HCWs) provide almost all vaccine services in Croatia, so they play an essential role in vaccine recommendations and uptake. The aim of this study was to determine the level of vaccine hesitancy among primary HCWs, to identify differences between nurses and physicians in attitudes, beliefs and behaviours towards vaccination, and to determine predictors of vaccine hesitancy among HCWs. We conducted a cross-sectional study from July to December in 2018 among physicians and nurses employed in the services of epidemiology, public health, school medicine, pediatrics and general practice/family medicine in Primorje-Gorski Kotar County, a primarily urban region with a population around 300 000 in the northern part of Croatia. The list of primary HCWs offices was obtained from the Croatian Health Insurance Fond website. We used a self-administered questionnaire on their attitudes, beliefs and behaviours relative to vaccination. Obtained response rate was 65.5% (324/495) of eligible primary HCWs; 64.1% (143/223) of physicians and 66.5% (181/272) of nurses. Seventeen percent of HCWs were identified as vaccine hesitant, and in univariate analysis, we observed an association between HCWs occupation and their own vaccination against flu (p = 0.001), measles (p = 0.016) and HPV (p = 0.025). Nurses and physicians differed (p < 0.001) in their general attitude, beliefs and behaviours towards vaccination, with a higher level of hesitancy among nurses. In multiple logistic regression, those more likely to be vaccine-hesitant were nurses (AOR = 5.73, 95%CI = 2.48-13.24), those who were uncertain or would never receive a vaccine against measles (AOR=11.13; 95%CI=5.37-23.10) and HPV (AOR=5.02; 95%CI=2.60-9.74), as well as those who had encountered a serious adverse event following immunization (AOR=7.55; 95%CI=3.13-19.18). As personal hesitancy may have a negative impact on vaccination education and recommendations, and therefore vaccine coverage, it is necessary to implement interventions to increase vaccination knowledge and confidence among primary health care workers, especially nurses.
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Affiliation(s)
- Morana Tomljenovic
- School of Medicine, University of Rijeka, Brace Branchetta 20/1, 51 000 Rijeka, Croatia; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), Gustav III:s Boulevard 40, Solna, Sweden.
| | - Goranka Petrovic
- Croatian Institute of Public Health, Rockefeller Street 7, 10 000 Zagreb, Croatia
| | - Nataša Antoljak
- Croatian Institute of Public Health, Rockefeller Street 7, 10 000 Zagreb, Croatia; School of Medicine, University of Zagreb, Salata 3, 10 000 Zagreb, Croatia
| | - Lisa Hansen
- National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, Netherlands
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30
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Baldolli A, Michon J, Verdon R, Fournier A. Vaccination perception and coverage among healthcare students in France in 2019. BMC Med Educ 2020; 20:508. [PMID: 33317501 PMCID: PMC7734903 DOI: 10.1186/s12909-020-02426-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/06/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Vaccine hesitancy in healthcare workers has been increasing especially in France while they are the cornerstone of vaccination programs. Greater understanding of healthcare students (HCS) vaccine knowledge, attitudes and beliefs is necessary to provide an adequate vaccination education to better equip them to promote vaccination in their future careers. The aim of this study was to assess vaccination perception (VP) (perception of benefits and risks of vaccines) and its impact on vaccination coverage (VC) for mandatory and recommended vaccines among HCS. METHODS A standardized, anonymous self-reporting electronic questionnaire was prospectively sent to HCS (medicine, nursing, pharmacy, midwifery, physiotherapy students and 1st year of health sciences students) of Normandy University in France between 18/03/2019 and 8/04/2019. VP was evaluated with questions regarding vaccination hesitancy, safety of vaccine and the benefit/risk balance of vaccination. Global VC (GVC) was defined as being vaccinated according to the mandatory and/or recommended vaccination schedule by national French law in 2018. RESULTS 542 HCS took part in this survey. VC was high for mandatory (diphtheriae, poliomyelitis, tetanus 93.5%, hepatitis B virus 88.6%) and even most of recommended vaccinations (measles 95%, pertussis 88.2%). Global VC (40.4%) was not statistically different between HCS except for 1st year health sciences students who were less vaccinated (25.6%). Regarding VP, 97.8% of HCS thought that vaccine are effective. When vaccine safety and level of vaccine hesitancy were assessed (on a 0-10 scale, 0: not safe or not hesitant and 10: completely safe and strongly hesitant for vaccine), 91% of respondents stated that vaccine safety is ≥7 and in 80% the vaccine hesitancy was < 3. There was no difference among student categories. 80.6% of HCS recommended all vaccines but only 52% agreed that flu vaccination should be mandatory for HCS. In the multivariate analysis, being a 1st year health care sciences student was associated with a lower GVC (OR 95% CI = 2 [1.2-3.3], p = 0.004) than being a medical student. CONCLUSION HCS perceived vaccine as effective and secure. Despite the good perception of vaccines, less than half HCS are well vaccinated.
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Affiliation(s)
- Aurélie Baldolli
- Department of Infectious Diseases, CHU de Caen, Avenue de la Côte de Nacre, F-14000, Caen, France.
| | - Jocelyn Michon
- Department of Infectious Diseases, CHU de Caen, Avenue de la Côte de Nacre, F-14000, Caen, France
| | - Renaud Verdon
- Department of Infectious Diseases, CHU de Caen, Avenue de la Côte de Nacre, F-14000, Caen, France
- Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Université Caen Normandie, F-14000, Caen, France
| | - Anna Fournier
- Department of Infectious Diseases, CHU de Caen, Avenue de la Côte de Nacre, F-14000, Caen, France
- Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Université Caen Normandie, F-14000, Caen, France
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31
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Filia A, Bella A, D'Ancona F, Fabiani M, Giambi C, Rizzo C, Ferrara L, Pascucci MG, Rota MC. Childhood vaccinations: knowledge, attitudes and practices of paediatricians and factors associated with their confidence in addressing parental concerns, Italy, 2016. ACTA ACUST UNITED AC 2020; 24. [PMID: 30755294 PMCID: PMC6373065 DOI: 10.2807/1560-7917.es.2019.24.6.1800275] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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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Affiliation(s)
- Antonietta Filia
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Antonino Bella
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Fortunato D'Ancona
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Massimo Fabiani
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Cristina Giambi
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Caterina Rizzo
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Lorenza Ferrara
- Regional Epidemiology Unit for Infectious Diseases (SeREMI), ASL, Alessandria, Italy
| | | | - Maria Cristina Rota
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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Bocquier A, Fressard L, Cortaredona S, Ward J, Seror V, Peretti-Watel P, Verger P. [Vaccine hesitancy in France: prevalence and association with parents' socioeconomic status]. Med Sci (Paris) 2020; 36:461-464. [PMID: 32452367 DOI: 10.1051/medsci/2020076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Aurélie Bocquier
- Aix-Marseille Université, IRD, AP-HM, Service de Santé des Armées (SSA), Vecteurs -Infections Tropicales et Méditeranéennes (VITROME), Marseille, France. - Institut hospitalo-universitaire Méditerranée infection, 19-21 boulevard Jean Moulin, 13385 Marseille Cedex 05, France - Observatoire régional de la santé Provence-Alpes-Côte d'Azur (ORS PACA), Marseille, France
| | - Lisa Fressard
- Aix-Marseille Université, IRD, AP-HM, Service de Santé des Armées (SSA), Vecteurs -Infections Tropicales et Méditeranéennes (VITROME), Marseille, France. - Institut hospitalo-universitaire Méditerranée infection, 19-21 boulevard Jean Moulin, 13385 Marseille Cedex 05, France - Observatoire régional de la santé Provence-Alpes-Côte d'Azur (ORS PACA), Marseille, France
| | - Sébastien Cortaredona
- Aix-Marseille Université, IRD, AP-HM, Service de Santé des Armées (SSA), Vecteurs -Infections Tropicales et Méditeranéennes (VITROME), Marseille, France. - Institut hospitalo-universitaire Méditerranée infection, 19-21 boulevard Jean Moulin, 13385 Marseille Cedex 05, France
| | - Jeremy Ward
- Aix-Marseille Université, IRD, AP-HM, Service de Santé des Armées (SSA), Vecteurs -Infections Tropicales et Méditeranéennes (VITROME), Marseille, France. - CNRS, Université Paris-Sorbonne, Groupe d'Étude des Méthodes de l'Analyse Sociologique de la Sorbonne (GEMASS), Paris, France
| | - Valérie Seror
- Aix-Marseille Université, IRD, AP-HM, Service de Santé des Armées (SSA), Vecteurs -Infections Tropicales et Méditeranéennes (VITROME), Marseille, France. - Institut hospitalo-universitaire Méditerranée infection, 19-21 boulevard Jean Moulin, 13385 Marseille Cedex 05, France
| | - Patrick Peretti-Watel
- Aix-Marseille Université, IRD, AP-HM, Service de Santé des Armées (SSA), Vecteurs -Infections Tropicales et Méditeranéennes (VITROME), Marseille, France. - Institut hospitalo-universitaire Méditerranée infection, 19-21 boulevard Jean Moulin, 13385 Marseille Cedex 05, France - Observatoire régional de la santé Provence-Alpes-Côte d'Azur (ORS PACA), Marseille, France
| | - Pierre Verger
- Aix-Marseille Université, IRD, AP-HM, Service de Santé des Armées (SSA), Vecteurs -Infections Tropicales et Méditeranéennes (VITROME), Marseille, France. - Institut hospitalo-universitaire Méditerranée infection, 19-21 boulevard Jean Moulin, 13385 Marseille Cedex 05, France - Observatoire régional de la santé Provence-Alpes-Côte d'Azur (ORS PACA), Marseille, France - Inserm, French Clinical Research Infrastructure Network (F-CRIN), Innovative clinical research network in vaccinology (I-REIVAC), Paris, France
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Kopp A, Mangin O, Gantzer L, Lekens B, Simoneau G, Ravelomanantsoa M, Evans J, Bergmann JF, Sellier P. Pneumococcal vaccination coverage in France by general practitioners in adults with a high risk of pneumococcal disease. Hum Vaccin Immunother 2020; 17:162-169. [PMID: 32429734 DOI: 10.1080/21645515.2020.1756669] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Streptococcus pneumoniae, the main cause of community-acquired pneumonia (CAP), also leads to exacerbations, hospitalizations, and mortality in chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF). The risk of CAP is increased in patients with diabetes mellitus (DM), and the risk of invasive pneumococcal disease is increased in HIV-infected patients. Pneumococcal vaccination is recommended for these patients in France. The objective was a large survey of pneumococcal vaccination coverage (PVC) by general practitioners (GPs) in these patients in France. Diagnosis and treatment forms were extracted from the database of 2000 GPs. The GPs and population panels were representative of the metropolitan populations. The primary endpoint was the comparison of PVC in the adult patients diagnosed with COPD, CHF, DM, or HIV infection during the study (April 2013-April 2017) and the control (March 2012-March 2013) periods. Of the 17,865 and 4,690 patients identified, 756 (4%) and 267 (6%) were vaccinated, respectively. During the study period, the PVC was significantly higher (35/282, 12%) in HIV-infected patients and lower in patients with DM (95/5994, 2%) than in other patients. Even though French pneumococcal vaccine recommendations in adults were updated in 2013, the PVC did not increase according to the years of the study period and slightly increased according to time after diagnosis. S. pneumoniae is responsible only for some CAP and meningitis, and incomplete protection by vaccine, hesitancy from practitioners and patients, and the moving schedule of vaccination could explain the results. New tools and/or strategies must be implemented to increase PVC in France. Abbreviations: CAP: community-acquired pneumonia; COPD: chronic obstructive pulmonary diseases; CHF: congestive heart failure; DM: diabetes mellitus; IPD: invasive pneumococcal disease; HIV: human immunodeficiency virus; PVC: pneumococcal vaccination coverage; PCV7: 7-valent pneumococcal conjugate vaccine; PCV13: 13-valent pneumococcal conjugate vaccine; PPSV23: 23-valent pneumococcal polysaccharide vaccine; GPs: general practitioners; CLM: Cegedim Logiciels Médicaux; MLM: monLogicielMedical; ICD-10: International Classification of Diseases; CNIL: Commission nationale de l'informatique et des libertés; HPV: human papillomavirus; HBV: hepatitis B virus.
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Affiliation(s)
- Aude Kopp
- Département de Médecine Interne, GH Saint-Louis-Lariboisière-Fernand Widal, AP-HP , Paris, France
| | - Olivier Mangin
- Département de Médecine Interne, GH Saint-Louis-Lariboisière-Fernand Widal, AP-HP , Paris, France
| | - Laurène Gantzer
- Cegedim Logiciels Médicaux (CLM®), GERSDATA, GERS SAS , Boulogne-Billancourt, France
| | - Béranger Lekens
- Cegedim Logiciels Médicaux (CLM®), GERSDATA, GERS SAS , Boulogne-Billancourt, France
| | - Guy Simoneau
- Département de Médecine Interne, GH Saint-Louis-Lariboisière-Fernand Widal, AP-HP , Paris, France
| | | | - John Evans
- Département de Médecine Interne, GH Saint-Louis-Lariboisière-Fernand Widal, AP-HP , Paris, France
| | - Jean-François Bergmann
- Département de Médecine Interne, GH Saint-Louis-Lariboisière-Fernand Widal, AP-HP , Paris, France
| | - Pierre Sellier
- Département de Médecine Interne, GH Saint-Louis-Lariboisière-Fernand Widal, AP-HP , Paris, France
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Bocquier A, Cortaredona S, Fressard L, Galtier F, Verger P. Seasonal influenza vaccination among people with diabetes: influence of patients' characteristics and healthcare use on behavioral changes. Hum Vaccin Immunother 2020; 16:2565-2572. [PMID: 32209014 PMCID: PMC7644174 DOI: 10.1080/21645515.2020.1729628] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Annual seasonal influenza vaccination (SIV) is recommended for people with diabetes, but vaccine coverage remains low. We estimated the probabilities of stopping or starting SIV, their correlates, and the expected time spent in the vaccinated state over 10 seasons for different patient profiles. We set up a retrospective cohort study of patients with diabetes in 2006 (n = 16,026), identified in a representative sample of beneficiaries of the French National Health Insurance Fund. We followed them up over 10 seasons (2005/06–2015/16). We used a Markov model to estimate transition probabilities and a proportional hazards model to study covariates. Between two consecutive seasons, the probabilities of starting (0.17) or stopping (0.09) SIV were lower than those of remaining vaccinated (0.91) or unvaccinated (0.83). Men, older patients, those with type 1 diabetes, treated diabetes or more comorbidities, frequent contacts with doctors, and with any hospital stay for diabetes or influenza during the last year were more likely to start and/or less likely to stop SIV. The mean expected number of seasons with SIV uptake over 10 seasons (range: 2.6–7.9) was lowest for women <65 years with untreated diabetes and highest for men ≥65 years with type 1 diabetes. Contacts with doctors and some clinical events may play a key role in SIV adoption. Healthcare workers have a crucial role in reducing missed opportunities for SIV. The existence of empirical patient profiles with different patterns of SIV uptake should encourage their use of tailored educational approaches about SIV to address patients’ vaccine hesitancy.
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Affiliation(s)
- A Bocquier
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME , Marseille, France.,IHU-Méditerranée Infection , Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur , Marseille, France
| | - S Cortaredona
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME , Marseille, France.,IHU-Méditerranée Infection , Marseille, France
| | - L Fressard
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME , Marseille, France.,IHU-Méditerranée Infection , Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur , Marseille, France
| | - F Galtier
- INSERM, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-Reivac), GH Cochin Broca Hôtel Dieu , Paris, France.,CIC 1411, CHU Montpellier, Hôpital Saint Eloi , Montpellier, France
| | - P Verger
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME , Marseille, France.,IHU-Méditerranée Infection , Marseille, France.,ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur , Marseille, France.,INSERM, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-Reivac), GH Cochin Broca Hôtel Dieu , Paris, France
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Affiliation(s)
- Jeremy K Ward
- CNRS, Université Paris-Sorbonne, GEMASS, Paris, France. .,Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.
| | - Patrick Peretti-Watel
- Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,INSERM, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
| | - Aurélie Bocquier
- Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Valérie Seror
- Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Pierre Verger
- Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,INSERM, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France
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Rosso A, Massimi A, Pitini E, Nardi A, Baccolini V, Marzuillo C, De Vito C, Villari P. Factors affecting the vaccination choices of pregnant women for their children: a systematic review of the literature. Hum Vaccin Immunother 2020; 16:1969-1980. [PMID: 31916903 PMCID: PMC7482832 DOI: 10.1080/21645515.2019.1698901] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
In recent years, an increase in vaccine hesitancy has led to a decrease in vaccination coverage in several countries. We conducted a systematic review of studies that assessed knowledge of and attitudes toward pediatric vaccinations, and the vaccination choices and their determinants among pregnant women. A total of 6,277 records were retrieved, and 16 full texts were included in the narrative synthesis. The published literature on the topic shows that, overall, pregnant women believe that vaccines are important for the protection of their children and the community, but various concerns and misunderstandings persist around vaccine safety and efficacy, which reduce the trust of expectant mothers in immunization. Nevertheless, such attitudes and choices vary depending on the vaccine being considered and the corresponding determinants should therefore be studied in the context of each specific vaccination. Further research on this topic is needed, particularly in non-western countries.
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Affiliation(s)
- Annalisa Rosso
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy.,Local Health Unit-Azienda Sanitaria Locale Roma 2 , Rome, Italy
| | - Azzurra Massimi
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - Erica Pitini
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - Angelo Nardi
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - Valentina Baccolini
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - Carolina Marzuillo
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - Corrado De Vito
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
| | - Paolo Villari
- Deparment of Public Health and Infectious Diseases, Sapienza University of Rome , Rome, Italy
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Wilson R, Zaytseva A, Bocquier A, Nokri A, Fressard L, Chamboredon P, Carbonaro C, Bernardi S, Dubé E, Verger P. Vaccine hesitancy and self-vaccination behaviors among nurses in southeastern France. Vaccine 2020; 38:1144-1151. [DOI: 10.1016/j.vaccine.2019.11.018] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 11/17/2022]
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Hadjipanayis A, van Esso D, Del Torso S, Dornbusch HJ, Michailidou K, Minicuci N, Pancheva R, Mujkic A, Geitmann K, Syridou G, Altorjai P, Pasinato A, Valiulis A, Soler P, Cirstea O, Illy K, Mollema L, Mazur A, Neves A, Zavrsnik J, Lapii F, Efstathiou E, Kamphuis M, Grossman Z. Vaccine confidence among parents: Large scale study in eighteen European countries. Vaccine 2019; 38:1505-1512. [PMID: 31848051 DOI: 10.1016/j.vaccine.2019.11.068] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 11/18/2019] [Accepted: 11/26/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Despite the fact that vaccines save 2-3 million lives worldwide every year, a percentage of children are not getting appropriately vaccinated, thus leading to disease outbreaks. One of the major reasons of low vaccine uptake in Europe is vaccine hesitancy, contributing to the recent measles outbreaks. Monitoring of vaccine hesitancy is valuable in early identification of vaccine concerns. METHODS We performed an eighteen country European survey on parents' attitudes and behaviors regarding their children's immunization. Parents having at least one child 1-4 years old were mostly recruited by primary care paediatricians to reply to a web-based questionnaire. The questionnaire was developed by the European Academy of Paediatrics Research in Ambulatory Setting Network steering committee, based on similar surveys. An individual level hesitancy score was constructed using the answers to 21 questions, and correlations of the score with socio-demographic characteristics and types of providers were explored. To assess inter country differences, a country level self -reported confidence was defined. RESULTS Fifty six percent and 24% of 5736 respondents defined themselves as "not at all hesitant", and "somewhat hesitant", respectively. Parents who consulted general practitioners were more hesitant than parents who consulted pediatricians (p < 0.05). Consultation with homeopathists was associated with the highest reported hesitancy (p < 0.05). Vaccine confidence was highest in Portugal and Cyprus, and lowest in Bulgaria and Poland. CONCLUSION The majority of parents in Europe believe in the importance of childhood vaccination. However, significant lack of confidence was found in certain European countries, highlighting the need for continuous monitoring, awareness and response plans. The possible influence of different types of healthcare providers on parental decisions demonstrated for the first time in our survey, calls for further research. Monitoring and continuous medical education efforts aimed mostly at those professionals who might not be likely to recommend vaccination are suggested.
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Affiliation(s)
- Adamos Hadjipanayis
- Paediatric Department, Larnaca General Hospital, Inomenon Polition, Larnaca 6042, Cyprus; European University Medical School, 6, Diogenis Street, Engomi, 1516 Nicosia, Cyprus.
| | - Diego van Esso
- Primary Care Service, Catalan Institute of Health, Barcelona, Spain
| | | | | | - Kyriaki Michailidou
- Department of Electron Microscopy/Molecular Pathology and Cyprus School of Molecular Medicine, The Cyprus Institute of Neurology and Genetics, Cyprus.
| | | | - Ruzha Pancheva
- Department of Hygiene and Epidemiology, Faculty of Public Health, Prof. Paraskev Stoyanov Medical University, Bulgaria
| | - Aida Mujkic
- University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Zagreb, Croatia.
| | | | - Garyfallia Syridou
- Paediatric Department, Thriasio General Hospital of Elefsina Athens, Greece
| | - Peter Altorjai
- Tóth Ilona Healthcare Service, Primary Paediatric Care Offices Görgey Artúr tér 8, Budapest H-1212, Hungary
| | - Angela Pasinato
- Pediatra di libera scelta, Azienda 8 Berica, Pediatra, Vicenza, Italy
| | - Arunas Valiulis
- Vilnius University Faculty of Medicine, Institute of Clinical Medicine and Institute of Health Sciences, Vilnius City Clinical Hospital, Vilnius, Lithuania.
| | - Paul Soler
- Department of Child & Adolescent Health, Mater Dei Hospital Msida, Malta.
| | - Olga Cirstea
- Department of Pediatrics, State University of Medicine and Pharmacy "Nicolae Testemitanu"Chisinau, Republic of Moldova.
| | - Károly Illy
- Department of Paediatrics, Ziekenhuis Rivierenland, Tiel, the Netherlands.
| | - Liesbeth Mollema
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
| | - Artur Mazur
- Medical Faculty, University of Rzeszów, Rzeszów, Poland.
| | - Ana Neves
- Pediatric Allergy Unit, Pediatric Department, University Hospital of Santa Maria, Faculty of Medicine, Lisbon University, Portugal
| | - Jernej Zavrsnik
- Community Health Center "dr. Adollf Drolc", Maribor, Slovenia.
| | - Fedir Lapii
- National Medical Academy of Postgraduate Education, Department of Pediatric Infectious Diseases and Pediatric Immunology, Kyiv, Ukraine
| | | | - Mascha Kamphuis
- Dutch Expertise Center Child Abuse, Utrecht, the Netherlands.
| | - Zachi Grossman
- Pediatric Clinic, Maccabi Healthcare Services, Tel Aviv, Israel.
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Maltezou HC, Botelho-Nevers E, Brantsæter AB, Carlsson RM, Heininger U, Hübschen JM, Josefsdottir KS, Kassianos G, Kyncl J, Ledda C, Medić S, Nitsch-Osuch A, de Lejarazu RO, Theodoridou M, Van Damme P, van Essen GA, Wicker S, Wiedermann U, Poland GA. Vaccination of healthcare personnel in Europe: Update to current policies. Vaccine 2019; 37:7576-7584. [PMID: 31623916 DOI: 10.1016/j.vaccine.2019.09.061] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 09/17/2019] [Accepted: 09/18/2019] [Indexed: 11/29/2022]
Abstract
We investigated and compared current national vaccination policies for health-care personnel (HCP) in Europe with results from our previous survey. Data from 36 European countries were collected using the same methodology as in 2011. National policies for HCP immunization were in place in all countries. There were significant differences in terms of number of vaccinations, target HCP and healthcare settings, and implementation regulations (recommended or mandatory vaccinations). Vaccination policies against hepatitis B and seasonal influenza were present in 35 countries each. Policies for vaccination of HCP against measles, mumps, rubella and varicella existed in 28, 24, 25 and 19 countries, respectively; and against tetanus, diphtheria, pertussis and poliomyelitis in 21, 20, 19, and 18 countries, respectively. Recommendations for hepatitis A immunization existed in 17 countries, and against meningococcus B, meningococcus C, meningococcus A, C, W, Y, and tuberculosis in 10, 8, 17, and 7 countries, respectively. Mandatory vaccination policies were found in 13 countries and were a pre-requisite for employment in ten. Comparing the vaccination programs of the 30 European countries that participated in the 2011 survey, we found that more countries had national vaccination policies against measles, mumps, rubella, hepatitis A, diphtheria, tetanus, poliomyelitis, pertussis, meningococcus C and/or meningococcus A, C, W, Y; and more of these implemented mandatory vaccination policies for HCP. In conclusion, European countries now have more comprehensive national vaccination programs for HCP, however there are still gaps. Given the recent large outbreaks of vaccine-preventable diseases in Europe and the occupational risk for HCP, vaccination policies need to be expanded and strengthened in several European countries. Overall, vaccination policies for HCP in Europe should be periodically re-evaluated in order to provide optimal protection against vaccine-preventable diseases and infection control within healthcare facilities for HCP and patients.
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Affiliation(s)
- Helena C Maltezou
- Department for Interventions in Health Care Facilities, Hellenic Centre for Disease Control and Prevention, Athens, Greece.
| | - Elisabeth Botelho-Nevers
- Clinical Trial Center, INSERM CICEC 1408, and Infectious Diseases Department, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France
| | - Arne B Brantsæter
- Department of Infectious Diseases and Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | | | | | | | - Kamilla S Josefsdottir
- Centre for Health Security and Communicable Disease Control, Directorate of Health, Reykjavik, Iceland
| | - George Kassianos
- Royal College of General Practitioners, Wokingham, United Kingdom
| | - Jan Kyncl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic; Department of Epidemiology and Biostatistics, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Caterina Ledda
- Occupational Medicine, Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Snežana Medić
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; Centre for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Aneta Nitsch-Osuch
- Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
| | - Raul Ortiz de Lejarazu
- National Influenza Centre, School of Medicine, Microbiology and Immunology Department, Hospital Clinico Universitario, Valladolid, Spain
| | - Maria Theodoridou
- Aghia Sophia Children's Hospital, First Department of Pediatrics, University of Athens, Athens, Greece
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | | | - Sabine Wicker
- Occupational Health Service, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Ursula Wiedermann
- Institute of Specific Prophylaxis and Tropical Medicine, Medical University Vienna, Vienna, Austria
| | - Gregory A Poland
- Director, Mayo Vaccine Research Group, Mayo Clinic, Rochester, MN, United States
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Collange F, Zaytseva A, Pulcini C, Bocquier A, Verger P. Unexplained variations in general practitioners' perceptions and practices regarding vaccination in France. Eur J Public Health 2019; 29:2-8. [PMID: 30085024 DOI: 10.1093/eurpub/cky146] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Given geographical disparities in vaccination coverage (VC) and the crucial role general practitioners (GPs) play in vaccination in France, we sought to: 1) determine the existence of geographical variations in GPs' perceptions of vaccines, their trust in information sources, and the frequency of their recommendations to patients by comparing data from southeast (SE), central-west (CW), northwest (NW), and the rest of France; and 2) identify individual and contextual factors associated with regional variations in GPs' recommendations. Methods This cross-sectional observational study in 2014 collected data from a panel of 2586 French GPs in private practice: 3 specific regional samples and a fourth sample for the rest of France. We calculated a composite score summarizing GPs' vaccine recommendation frequency for 6 vaccine situations and used a five-step hierarchical linear regression to study the score's links with practice location and individual and contextual factors. Results GPs' vaccine recommendation frequency score was highest in NW France and lowest in the SE. The low SE score was explained by GPs' greater doubts about vaccine utility and risks and lower trust in information sources. The high NW score was partially explained by greater adherence to guidelines by GPs there. The contextual factors studied did not explain regional differences. Conclusion The geographical variations in GPs' vaccination-related attitudes and practices suggest that vaccine hesitancy among GPs differs in prevalence between regions. These variations coincide with north/south trends in population VC. Intervention strategies to restore confidence in vaccines should target GPs and must be adapted to each regional context.
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Affiliation(s)
- Fanny Collange
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France.,Southeastern Health Regional Observatory, ORS PACA, Marseille, France
| | - Anna Zaytseva
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France.,Southeastern Health Regional Observatory, ORS PACA, Marseille, France
| | - Céline Pulcini
- Université de Lorraine, EA 4360 APEMAC and, CHRU de Nancy, Service de Maladies Infectieuses et Tropicales, Nancy, France
| | - Aurélie Bocquier
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France.,Southeastern Health Regional Observatory, ORS PACA, Marseille, France
| | - Pierre Verger
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France.,Southeastern Health Regional Observatory, ORS PACA, Marseille, France
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Maltezou HC, Ledda C, Rapisarda V. Mandatory vaccinations for children in Italy: The need for a stable frame. Vaccine 2019; 37:4419-4420. [PMID: 31280946 DOI: 10.1016/j.vaccine.2019.05.095] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/13/2019] [Accepted: 05/22/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Helena C Maltezou
- Department for Interventions in Healthcare Facilities, Hellenic Centre for Disease Control and Prevention, Athens, Greece.
| | - Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Italy
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Italy
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Detoc M, Touche C, Charles R, Lucht F, Gagneux-Brunon A, Botelho-Nevers E. Primary physicians' attitudes toward their patients receiving a proposal to participate in a vaccine trial. Hum Vaccin Immunother 2019; 15:2969-2979. [PMID: 31241393 DOI: 10.1080/21645515.2019.1625646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
A trustworthy relationship between primary physicians (PPs) and their patients is crucial for vaccine acceptance. Little is known about attitudes of PPs toward participation of their patients in a preventive vaccine trial (PVT) proposed by investigation sites.A cross-sectional study was conducted in Auvergne-Rhône-Alpes region (France) including an anonymous questionnaire for general practitioners (GPs) and other specialists as well as face-to-face interviews. A scenario of a patient, with chronic medical conditions, invited to participate in a PVT and reporting this situation to his/her PP was drawn up. PPs' attitudes were assessed in quantitative approach by a 5-point Likert scale and in qualitative approach by semi-directed individual interviews.Among the 521 respondents to the questionnaire, 429 (82.3%) were GPs and 92 (17.7%) were other specialists. Only 7.5% (39/521) of respondents regularly practice clinical research. Confronted with the scenario, 312 respondents (59.8%) declared they would give their opinion spontaneously. Before giving their opinion, PPs would like more information about the trial (91.4%, n = 476). Whatever their attitude, 488 (93.7%) would be influenced by available safety data. Face-to-face interviews confirmed that PPs lack of knowledge about clinical research, and would like to obtain information from investigators, particularly about safety.PPs seem to be concerned by the decision of their patients to participate or not in a PVT but would like more information about the trial and clinical research before giving their opinion. Getting PPs to be more involved in the enrollment of patients in PVT may improve recruitment.
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Affiliation(s)
- Maelle Detoc
- Clinical trial center, INSERM CICEC 1408, University Hospital of Saint-Etienne, Saint-Etienne, France.,Groupe Immunité Muqueuse et Agents Pathogènes (GIMAP), EA3064 - Medical School of Saint-Etienne, University of Lyon, Saint-Etienne, France
| | - Camille Touche
- General Practice Department, University of Lyon, Saint-Etienne, France
| | - Rodolphe Charles
- General Practice Department, University of Lyon, Saint-Etienne, France
| | - Frédéric Lucht
- Clinical trial center, INSERM CICEC 1408, University Hospital of Saint-Etienne, Saint-Etienne, France.,Groupe Immunité Muqueuse et Agents Pathogènes (GIMAP), EA3064 - Medical School of Saint-Etienne, University of Lyon, Saint-Etienne, France
| | - Amandine Gagneux-Brunon
- Clinical trial center, INSERM CICEC 1408, University Hospital of Saint-Etienne, Saint-Etienne, France.,Groupe Immunité Muqueuse et Agents Pathogènes (GIMAP), EA3064 - Medical School of Saint-Etienne, University of Lyon, Saint-Etienne, France
| | - Elisabeth Botelho-Nevers
- Clinical trial center, INSERM CICEC 1408, University Hospital of Saint-Etienne, Saint-Etienne, France.,Groupe Immunité Muqueuse et Agents Pathogènes (GIMAP), EA3064 - Medical School of Saint-Etienne, University of Lyon, Saint-Etienne, France
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Napolitano F, Della Polla G, Angelillo IF. Knowledge, Attitudes, and Behaviors of Parents towards Recommended Adult Vaccinations: An Explanatory Survey in the Geographic Area of Naples, Italy. Int J Environ Res Public Health 2019; 16:ijerph16122070. [PMID: 31212739 PMCID: PMC6616468 DOI: 10.3390/ijerph16122070] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/01/2019] [Accepted: 06/08/2019] [Indexed: 12/11/2022]
Abstract
The purposes of this study were to explore the knowledge, attitudes, and behaviors towards the recommended vaccinations for adults between 19–64 years of age and the associated factors among parents. The survey was conducted from October to December 2018 among a sample of parents randomly selected from five preschools and primary, secondary, and high schools in the geographic area of Naples, Italy. The mean age of participants was 45.2 years (range 19–71). Only 16% of the parents knew all vaccinations recommended to adults between 19–64 years of age. Those being healthcare professionals, having a chronic condition, having received information about vaccinations from physicians, and having a lower educational level were more likely to know the vaccinations recommended to adults between 19–64 years of age. Female participants, those who had received information about vaccinations from physicians, and those who had a lower number of children were more likely to have a positive attitude toward the usefulness of the administration of vaccinations recommended to adults between 19–64 years of age. Among unvaccinated respondents, more than half reported a positive attitude toward willingness to receive a recommended vaccination. This positive attitude was significantly higher among those who considered vaccinations as being useful and among who had received information from physicians. Only 16.9% self-reported to have received at least one vaccination recommended to adults between 19–64 years of age. Those who were healthcare professionals, who had at least one chronic condition, and who considered the administration of the vaccinations as being useful were more likely to have received at least one recommended vaccination. Greater efforts by policy makers and healthcare providers are needed to increase parents’ knowledge on recommended vaccines, and it is also crucial that healthcare providers have a high knowledge and favorable attitudes in order to increase vaccine coverage.
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Affiliation(s)
- Francesco Napolitano
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via L. Armanni, 5 80138 Naples, Italy.
| | - Giorgia Della Polla
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via L. Armanni, 5 80138 Naples, Italy.
| | - Italo Francesco Angelillo
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Via L. Armanni, 5 80138 Naples, Italy.
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Pichon M, Gaymard A, Zamolo H, Bazire C, Valette M, Sarkozy F, Lina B. Web-based analysis of adherence to influenza vaccination among French healthcare workers. J Clin Virol 2019; 116:29-33. [PMID: 31082729 DOI: 10.1016/j.jcv.2019.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 04/24/2019] [Accepted: 04/26/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Influenza is recognized as a public health threat. However, vaccine hesitancy and poor vaccine uptake have been seen in French healthcare workers (HCWs). As a result, authorities have considered implementing mandatory influenza vaccination for HCWs. OBJECTIVES This study aimed to describe factors associated with influenza vaccine adherence or non-adherence in French HCWs and to collect their perception about mandatory influenza vaccination. STUDY DESIGN In February 2017, during the influenza season, a standardized questionnaire was sent electronically to the professional email addresses of French HCWs. Analyses were performed having collected 3000 responses. RESULTS Between February 1 and 16, 2017, a 14-question survey was sent to HCWs professional email addresses. After a two week period had elaspsed, 3000 answers were collected for analysis. Overall, 45.7% of responders reported they had received influenza vaccination in 2016-2017, with statistical differences relating to professional status, age and practice. In addition, 92.2% reported caring for at-risk patients and 62.9% had a community-based practice. Finally, accepting mandatory influenza vaccination was statistically associated with higher age, a higher socio-professional category, and seasonal influenza vaccine uptake, but not with management of at-risk patients. CONCLUSIONS Electronically submitted questionnaires are a rapid and easy tool that can be used to describe factors associated with influenza vaccine uptake in HCWs. In our study, differences in receiving influenza vaccination related to age, practice and professional categories, and provided an insight into potential adherence to mandatory influenza vaccination in HCWs. If repeated, these surveys may also monitor the evolution of vaccine uptake by professional categories.
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Affiliation(s)
- Maxime Pichon
- Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Centre National de Référence des virus des infections respiratoires (dont la Grippe), HCL, Hôpital de la Croix-Rousse, 103 grande rue de la Croix-Rousse, 69317, Lyon Cedex 04, France; Virpath, CIRI, Université de Lyon, CIRI, Inserm U1111 CNRS UMR5308, ENS, UCBL, Faculté de Médecine Lyon Est, 7-11 rue Guillaume Paradin, 69372, Lyon Cedex 08, France
| | - Alexandre Gaymard
- Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Centre National de Référence des virus des infections respiratoires (dont la Grippe), HCL, Hôpital de la Croix-Rousse, 103 grande rue de la Croix-Rousse, 69317, Lyon Cedex 04, France; Virpath, CIRI, Université de Lyon, CIRI, Inserm U1111 CNRS UMR5308, ENS, UCBL, Faculté de Médecine Lyon Est, 7-11 rue Guillaume Paradin, 69372, Lyon Cedex 08, France
| | - Hugo Zamolo
- Tous pour la Santé, Healthcare Professional Digital Platform FSNB Health & Care, Paris, France
| | - Charlotte Bazire
- Tous pour la Santé, Healthcare Professional Digital Platform FSNB Health & Care, Paris, France
| | - Martine Valette
- Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Centre National de Référence des virus des infections respiratoires (dont la Grippe), HCL, Hôpital de la Croix-Rousse, 103 grande rue de la Croix-Rousse, 69317, Lyon Cedex 04, France
| | - François Sarkozy
- Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Centre National de Référence des virus des infections respiratoires (dont la Grippe), HCL, Hôpital de la Croix-Rousse, 103 grande rue de la Croix-Rousse, 69317, Lyon Cedex 04, France
| | - Bruno Lina
- Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Centre National de Référence des virus des infections respiratoires (dont la Grippe), HCL, Hôpital de la Croix-Rousse, 103 grande rue de la Croix-Rousse, 69317, Lyon Cedex 04, France; Virpath, CIRI, Université de Lyon, CIRI, Inserm U1111 CNRS UMR5308, ENS, UCBL, Faculté de Médecine Lyon Est, 7-11 rue Guillaume Paradin, 69372, Lyon Cedex 08, France.
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Wilson R, Scronias D, Zaytseva A, Ferry MA, Chamboredon P, Dubé E, Verger P. Seasonal influenza self-vaccination behaviours and attitudes among nurses in Southeastern France. Hum Vaccin Immunother 2019; 15:2423-2433. [PMID: 30829102 DOI: 10.1080/21645515.2019.1587274] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Despite seasonal influenza vaccination (SIV) being recommended to healthcare professionals to protect themselves and their patients, uptake is low, especially among nurses. We sought to study self-vaccination behaviours, attitudes and knowledge about SIV among nurses in Southeastern France. METHODS A cross-sectional survey with community and hospital-based hospital nurses was conducted with the same standardised questionnaire. Multi-model averaging approaches studied factors associated with the following dependent variables: self-reported SIV uptake; and considering SIV a professional responsibility. RESULTS 1539 nurses completed the questionnaire (response rate: 85%). SIV was the most frequently cited vaccine (49%) regarding nurses' unfavourable opinions towards specific vaccines. Thirty-four percent of nurses reported being vaccinated at least once during the 2015-2016 or 2016-2017 seasons. A lack of perceived personal vulnerability to influenza, a fear of adverse effects, and a preference for homeopathy constituted the main deterrents of SIV. Nurses held various misconceptions about the SIV, but 69% considered its benefits to be greater than its risks. The multi-model averaging approach showed that considering SIV as a professional responsibility was the main factor associated with SIV uptake among nurses (Nagelkerke's partial R-squared: 15%). This sense of responsibility was strongly associated with trust in various vaccine information sources. CONCLUSION Nurses had low SIV uptake rates and held various concerns and a lack of knowledge surrounding the vaccine. This is concerning considering the impact that these factors can have on nurses and patients' health, especially considering the increased role that nurses could have surrounding SIV in the near future.
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Affiliation(s)
- Rose Wilson
- ORS PACA, Southeastern Health Regional Observatory , Marseille , France.,IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Aix Marseille Univ , Marseille , France
| | - Dimitri Scronias
- IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Aix Marseille Univ , Marseille , France
| | - Anna Zaytseva
- ORS PACA, Southeastern Health Regional Observatory , Marseille , France.,IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Aix Marseille Univ , Marseille , France
| | - Marie-Ange Ferry
- Conseil Inter-Régional de l'Ordre des Infirmiers (CIROI) PACA , Corse , France
| | - Patrick Chamboredon
- Conseil Inter-Régional de l'Ordre des Infirmiers (CIROI) PACA , Corse , France
| | - Eve Dubé
- Department of Social and Preventive Medicine, Institut National de Santé publique du Québec , Québec , Canada
| | - Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory , Marseille , France.,IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Aix Marseille Univ , Marseille , France
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Bianco A, Mascaro V, Zucco R, Pavia M. Parent perspectives on childhood vaccination: How to deal with vaccine hesitancy and refusal? Vaccine 2019; 37:984-990. [DOI: 10.1016/j.vaccine.2018.12.062] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 12/12/2018] [Accepted: 12/21/2018] [Indexed: 10/27/2022]
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Abstract
INTRODUCTION Vaccinations of healthcare workers (HCWs) aim to directly protect them from occupational acquisition of vaccine-preventable diseases (VPDs) and to indirectly protect their patients and the essential healthcare infrastructure. However, outbreaks due to VPDs continue to challenge healthcare facilities and HCWs are frequently traced as sources of VPDs to vulnerable patients. In addition, HCWs were disproportionately affected during the current measles outbreak in Europe. Areas covered: We reviewed the recent published information about HCWs vaccinations with a focus on mandatory vaccination policies. Expert commentary: Although many countries have vaccination programs specifically for HCWs, their vaccination coverage remains suboptimal and a significant proportion of them remains susceptible to VPDs. The increasing vaccination hesitancy among HCWs is of concern, given their role as trusted sources of information about vaccines. Mandatory vaccinations for HCWs are implemented for specific VPDs in few countries. Mandatory influenza vaccination of HCWs was introduced in the United States a decade ago with excellent results. Mandatory vaccinations for VPDs that may cause significant morbidity and mortality should be considered. Issues of mistrust and misconceptions about vaccinations should also be addressed.
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Affiliation(s)
- Helena C Maltezou
- a Department for Interventions in Health-Care Facilities , Hellenic Center for Disease Control and Prevention , Athens , Greece
| | - Kalliopi Theodoridou
- b Department of Microbiology , Medical School of National and Kapodistrian University of Athens , Athens , Greece
| | - Caterina Ledda
- c Occupational Medicine, Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Venerando Rapisarda
- c Occupational Medicine, Department of Clinical and Experimental Medicine , University of Catania , Catania , Italy
| | - Maria Theodoridou
- d First Department of Pediatrics , National and Kapodistrian University of Athens , Athens , Greece
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Abstract
Vaccination has been identified many decades ago as an effective means to prevent several diseases. However, in France, there is an emergence of vaccine hesitancy, that has caused a reduction of vaccination coverage rates. This issue reduces the effectiveness of the immunization process, and represents a real threat to public health that should be urgently addressed. The purpose of this review is to present actions that have been taken to fight against vaccine hesitancy and thus enhance vaccine uptake. The results indicate that different strategies have been proposed to reach this goal, mainly by vaccination campaigns. These findings highlight the strong implication of national health authorities and the medical staff of hospitals and health-care centers. However, actions implemented should be part of a long-term approach, and further studies are required to identify the most effective strategies to address vaccine hesitancy.
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Affiliation(s)
- Cécile Fokoun
- a Hospices Civils de Lyon, Lyon Public Health Institute , Lyon , France
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Abstract
This cross-sectional survey was designed to assess the prevalence of vaccine hesitancy and to identify factors associated among a randomly selected sample of parents. A questionnaire was self-administered from October to December 2017 to a sample of parents of children aged 2 to 6 years attending five randomly selected pre-schools in the geographic area of Naples, Italy. Out of the 727 selected parents, 437 returned the questionnaires for a response rate of 60.1%. The median of Parent Attitudes about Childhood Vaccines Survey (PACV) score among participants was 45.8 with a total of 141 parents (34.7%) scored a value ≥50 and were defined hesitant about the childhood vaccinations. Vaccine hesitancy was significantly more common among those who were concerned and among those were not sure that any one of the childhood shots might not be safe, among those who were concerned that their children might have a serious side effect from a shot, among those who were concerned that a shot might not prevent the disease, among those who delayed and refused at least a shot of vaccine for their children, and in those who are not sure and uncertain in the pediatrician. More than half of parents (53.8%) expressed a desire to receive additional information about the childhood vaccinations. Parents who were not sure and uncertain that to follow the recommended shot schedule is a good idea for their children and those who were parents of first-born children were more likely to need additional information. This study finds a high prevalence of vaccine hesitancy among parents suggesting that in the immunization program is necessary to achieve a higher quality of the relationship between pediatricians and the community.
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Affiliation(s)
- Francesco Napolitano
- a Department of Experimental Medicine , University of Campania "Luigi Vanvitelli" , Naples , Italy
| | - Alessia D'Alessandro
- a Department of Experimental Medicine , University of Campania "Luigi Vanvitelli" , Naples , Italy
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