BackgroundThis study aimed to assess: 1) vaccine hesitancy (VH) prevalence among French general practitioners (GPs) through the frequency of their vaccine recommendations, and 2) the determinants of these recommendations.MethodsCross-sectional observational study in 2014 nested in a national panel of 1712 randomly selected GPs in private practice in France. We constructed a score of self-reported recommendation frequency for 6 specific vaccines to target populations.Results16% to 43% of GPs sometimes or never recommended at least one specific vaccine to their target patients. Multivariable logistic regressions of the dichotomized score showed that GPs recommended vaccines frequently when they felt comfortable explaining their benefits and risks to patients (OR = 1.87; 1.35–2.59), or trusted official sources of information highly (OR = 1.40; 1.01–1.93). They recommended vaccines infrequently when they considered that adverse effects were likely (OR = 0.71; 0.52–0.96) or doubted the vaccine's utility (OR = 0.21; 0.15–0.29).InterpretationOur findings show that after repeated vaccine controversies in France, some VH exists among French GPs, whose recommendation behaviors depend on their trust in authorities, their perception of the utility and risks of vaccines, and their comfort in explaining them. Further research is needed to confirm these results among health care workers in other countries.

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

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Context: General practitioners and family physicians (GP/FPs) play a key role in the vaccination of the public in many countries and serve as role models for their patients through their own health behaviors. Objectives and Methods: a) To search for and document recommended/mandated vaccines for GP/FPs in high-income countries; b) To systematically search and review the literature on these physicians' knowledge, attitudes, beliefs, and behaviors (KABB) toward their own vaccination with the recommended/ mandated vaccines and the factors determining it. Results: a) The 14 countries included recommended or mandated as many as 12 vaccines; b) The systematic review identified 11 studies published in the last 10 y. All considered seasonal influenza vaccination but differed in the variables investigated. Discussion/ Conclusions: This review highlights the need for further studies on this topic, including qualitative and interventional studies (based on behavior change theories). These should cover occupational vaccines and determinants known to be associated with vaccine hesitancy.

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.

The results of the first wave of surveys, conducted on a large sample of French GPs, provide important information to guide the French vaccination policy.

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