Barriers and drivers to adult vaccination among family physicians – Insights for tailoring the immunization program in Germany

Neufeind, Julia; Betsch, Cornelia; Habersaat, Katrine Bach; Eckardt, Matthias; Schmid, Philipp; Wichmann, Ole

doi:10.1016/j.vaccine.2020.04.052

Cited by 64 publications

(72 citation statements)

References 28 publications

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“…Japanese providers aware of Guillain–Barre syndrome cases associated with U.S. influenza vaccination were less likely to recommend the vaccine during the 2009 H1N1 pandemic [ 112 ]. Providers with higher confidence in their knowledge elected to receive influenza vaccine more frequently [ 106 ] and recommended vaccination for influenza 1.3–3.5 times [ 55 , 106 , 114 , 115 ] and pertussis 6.8 times more often [ 114 ]. Reasons for not suggesting vaccines included not being confident in offering counseling [ 81 ] and inadequate vaccine training [ 82 ].…”

Section: Resultsmentioning

confidence: 99%

Healthcare Providers’ Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review

et al. 2021

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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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Section: Resultsmentioning

confidence: 99%

Healthcare Providers’ Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review

et al. 2021

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“…Encouraging or incentivizing physicians to get vaccinated themselves may be an avenue to improve the low adult vaccination rates in Germany. 27 The strong correlation found between pneumococcal vaccination and influenza vaccination may provide an opportunity to increase pneumococcal vaccination rates, and the potential of bundling influenza and pneumococcal vaccines should be further investigated. 26 Before we can realistically expect further population-level reductions in VT IPD in older adults, we must engage with this age group and their care providers to increase the rate of vaccination.…”

Section: Rate Of Pneumococcal Vaccinationmentioning

confidence: 99%

Pneumococcal vaccine uptake and vaccine effectiveness in older adults with invasive pneumococcal disease in Germany

Perniciaro¹,

Linden²

2020

Preprint

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Background - Invasive pneumococcal disease (IPD) in people ≥60 years old is on the rise in Germany. There has been a recommendation for pneumococcal vaccination in this age group since 1998. Methods - We determined the vaccination status of people ≥60 years old with IPD in Germany. We assessed vaccine effectiveness (VE) of the recommended 23-valent polysaccharide vaccine (PPV23). Results - The rate of pneumococcal vaccination in older adults with IPD is low, 26%, with only 16% of people receiving a pneumococcal vaccine within the past 5 years. Age- and sex- adjusted vaccine effectiveness (VE) for PPV23 was 37% (95% confidence interval 12% - 55%). For people vaccinated with PPV23 less than 2 years prior to IPD, VE was -20% (-131% - 34%), between 2-4 years prior to IPD, VE was 56% (20% - 76%), and 47% (17% - 63%) for those vaccinated ≥5 years ago. Excluding serotype 3, overall VE for the remaining serotypes in PPV23 was 63% (49% - 74%). For people receiving PPV23 within the past 2 years, VE against all serotypes except 3 was 49% (12% - 71%); for people vaccinated between 2-4 years prior to IPD 66% (37% - 82%); for those vaccinated ≥5 years ago, 69% (50% - 81%). VE of PPV23 against serotype 3 IPD only was -110% (-198% - -47%). Conclusions - To reduce IPD in older adults in Germany, we must increase the rate of pneumococcal vaccine uptake. For 22/23 serotypes, PPV23 was effective. Serotype 3 remains a major problem.

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“…Twenty-nine studies contained nationwide data. For three of these studies (reported in four publications), the sample was drawn from the German residential register (2, 39-41), for two from other national registers (38,48) and for two from the health insurance refund claims of Associations of Statutory Health Insurance Physicians (ASHIP) (16,44).…”

Section: Study Characteristicsmentioning

confidence: 99%

Hepatitis B Vaccination Coverage in Germany: Systematic Review

Steffen

Sperle

Harder

et al. 2021

Preprint

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Background: Despite being considered as a low prevalence country for hepatitis B (HBV), some populations in Germany are at higher risk of infection. In the context of the World Health Organization’s (WHO) viral hepatitis elimination goals a valid epidemiological data base is needed to plan and monitor the national response. Prevention strategies include general and targeted HBV vaccination programmes. Objective: The aim of this work was to estimate the HBV vaccination coverage (VC) in the general population (GP) and different population groups in Germany from available evidence and to identify current evidence gaps for future research.Methods: We conducted a systematic review on HBV VC in the general population and populations at high risk of HBV exposure or severe infection in Germany. We included eligible publications (01/01/2017 to 06/06/2020) from databases Embase, Pubmed and Livivo, from a previous scoping review (including data published 01/01/2005-17/03/2017), from the national surveillance system and screened the reference lists of all publications at full text level. Risk of bias was assessed using the Hoy et al tool. Results: We included 68 publications of 67 studies and assigned them to the respective population groups. Twenty-one studies contained data among children/adolescents and three among adults from the GP (VC 65.8% - 90.5% and 22.9% - 52.1%, respectively), one among travellers to HBV endemic countries (VC 89%), 13 among immunocompromised populations (VC 11.5% - 89%), 16 among populations with occupational risk and 16 with non-occupational risk of HBV exposure (VC 63.6% - 96.5% and 4.4% - 52%, respectively). Conclusion: Comprehensive evidence at low risk of bias was identified for children/adolescents. owever, 25 years after including HBV in the national immunisation schedule, VC in Germany is still below the 95%-goal defined by WHO. For people at occupational risk of HBV exposure, VC was mostly reported to be over the WHO goal of 80%, but quality of evidence was heterogenous and should be improved. For people at non-occupational risk of HBV exposure, evidence was sparse and of low quality. The low VC highlights the need for future research to plan vaccination programmes targeting these populations.

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Barriers and drivers to adult vaccination among family physicians – Insights for tailoring the immunization program in Germany

Cited by 64 publications

References 28 publications

Healthcare Providers’ Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review

Healthcare Providers’ Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review

Pneumococcal vaccine uptake and vaccine effectiveness in older adults with invasive pneumococcal disease in Germany

Hepatitis B Vaccination Coverage in Germany: Systematic Review

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