Pandemic Influenza (A/H1N1) Vaccine Uptake among French Private General Practitioners: A Cross Sectional Study in 2010

Abstract

BackgroundIn July, 2009, French health authorities, like those in many other countries, decided to embark on a mass vaccination campaign against the pandemic A(H1N1) influenza. Private general practitioners (GPs) were not involved in this campaign. We studied GPs’ pandemic vaccine (pvaccine) uptake, quantified the relative contribution of its potential explanatory factors and studied whether their own vaccination choice was correlated with their recommendations to patients about pvaccination.Methodology/Principal FindingsIn this cross-sectional telephone survey, professional investigators interviewed an existing panel of randomly selected private GPs (N = 1431; response rate at inclusion in the panel: 36.8%; participation rate in the survey: 100%). The main outcome variable was GPs’ own pvaccine uptake. We used an averaging multi-model approach to quantify the relative contribution of factors associated with their vaccination. The pvaccine uptake rate was 61% (95%CI = 58.3–63.3). Four independent factors contributed the most to this rate (partial Nagelkerke’s R2): history of previous vaccination against seasonal influenza (14.5%), perception of risks and efficacy of the pvaccine (10.8%), opinions regarding the organization of the vaccination campaign (7.1%), and perception of the pandemic's severity (5.2%). Overall, 71.3% (95%CI = 69.0–73.6) of the participants recommended pvaccination to young adults at risk and 40.1% (95%CI = 37.6–42.7) to other young adults. GPs’ own pvaccination was strongly predictive of their recommendation to both young adults at risk (OR = 9.6; 95%CI = 7.2–12.6) and those not at risk (OR = 8.5; 95%CI = 6.4–11.4).Conclusions/SignificanceThese results suggest that around 60% of French private GPs followed French authorities’ recommendations about vaccination of health care professionals against the A(H1N1) influenza. They pinpoint priority levers for improving preparedness for future influenza pandemics. Besides encouraging GPs' own uptake of regular vaccination against seasonal influenza, providing GPs with clear information about the risks and efficacy of any new pvaccine and involving them in the organization of any future vaccine campaign may improve their pvaccine uptake.

Knowledge, attitudes, beliefs and behaviors of general practitioners/family physicians toward their own vaccination: A systematic review

“…29 Improving understanding of these physicians' KABB toward their own vaccination and the factors determining it is essential because they not only act as role models for their patients, but because their behaviors for themselves can be determinant in their recommendations to their patients. This has been shown in the case of vaccination against influenza (positive association between their own and their patients' vaccination against seasonal influenza, 20 personal acceptance of vaccination against pandemic influenza predictive of GP/FPs' recommendation of this vaccine to their patients 22 ), but also, for example, for prescription of psychotherapy (GP/FPs who have undergone psychotherapy are more likely to recommend it 53 ) or help in quitting were not aware of them and 10% were not sure if they were aware of any recommendation -Potential barriers to vaccination: 10% reported that this vaccination would not benefit them because they do not get the flu, having to pay for the vaccine was a barrier for 30% of them 2006, Semaille et al…”

“…[17][18][19][20][21] Moreover, their recommendations to patients about vaccinations are associated with their vaccination behaviors and attitudes for themselves. [22][23][24][25][26] Their own vaccination might be important as a proxy for their potential "vaccine hesitancy," -a term that describes vaccination reluctance and was first studied in the general population 27,28 and, more recently, also among GP/FPs. 28,29 For all these reasons, identifying factors associated with their own vaccinations is important for improving vaccination coverage rates in the general population.…”

General Practitioners' Choices and Their Determinants When Starting Treatment for Major Depression: A Cross Sectional, Randomized Case-Vignette Survey

“…The survey described was the third of a series nested in the national panel of French GPs, designed to collect data regularly about their activity and practices. Its methodology has been presented elsewhere [17]. Briefly, 5170 GPs were randomly selected from the Ministry of Health's exhaustive database of health professionals in France.…”

“…The GPs who refused to take part did not differ from participants according to practice location, but were more frequently male (p = 0.02), older (p<10 −3 ), and had a higher workload in 2008 (p<10 −3 ). Lack of time (46.2%) and lack of interest in the panel (15.6%) were the reasons given most frequently for refusal [17].…”

“…Using a national panel of 1431 GPs in private practice that was set up in June 2010 to study GPs' attitudes and practices regarding different public health problems [17], we conducted a cross-sectional survey to study how GPs manage the acute phase of new cases of non-comorbid major depression (MD). The first specific aim was to describe GPs' choices among several treatment modalities: watchful waiting (assessment with scheduled follow-up but no active medication or psychotherapy treatment) [18]; initiating pharmacological treatment; recommending psychotherapy; providing psychological support.…”