Likely correlation between sources of information and acceptability of A/H1N1 swine-origin influenza virus vaccine in Marseille, France.

Antoine Nougairède,Jean-Christophe Lagier,Michel Drancourt,Bernard La Scola,Didier Raoult,Xavier De Lamballerie,Elizabeth Botelho,Catherine Sartor,Laetitia Ninove,Rémi N Charrel,Ernest A Gould,Sékéné Badiaga,Philippe Brouqui,Christine Zandotti,Chaoyang Xue

doi:10.1371/journal.pone.0011292

Abstract

BackgroundIn France, there was a reluctance to accept vaccination against the A/H1N1 pandemic influenza virus despite government recommendation and investment in the vaccine programme.Methods and FindingsWe examined the willingness of different populations to accept A/H1N1vaccination (i) in a French hospital among 3315 employees immunized either by in-house medical personnel or mobile teams of MDs and (ii) in a shelter housing 250 homeless persons. Google was used to assess the volume of enquiries concerning incidence of influenza. We analyzed the information on vaccination provided by Google, the website of the major French newspapers, and PubMed. Two trust Surveys were used to assess public opinion on the trustworthiness of people in different professions. Paramedics were significantly more reluctant to accept immunisation than qualified medical staff. Acceptance was significantly increased when recommended directly by MDs. Anecdotal cases of directly observed severe infections were followed by enhanced acceptance of paramedical staff. Scientific literature was significantly more in favour of vaccination than Google and French newspaper websites. In the case of the newspaper websites, information correlated with their recognised political reputations, although they would presumably claim independence from political bias. The Trust Surveys showed that politicians were highly distrusted in contrast with doctors and pharmacists who were considered much more trustworthy.ConclusionsThe low uptake of the vaccine could reflect failure to convey high quality medical information and advice relating to the benefits of being vaccinated. We believe that the media and internet contributed to this problem by raising concerns within the general population and that failure to involve GPs in the control programme may have been a mistake. GPs are highly regarded by the public and can provide face-to-face professional advice and information. The top-down strategy of vaccine programme management and information delivered by the Ministry of Health could have aggravated the problem, because the general population does not always trust politicians.

Highlights

Following the confirmation by the World Health Organization, that A/H1N1 influenza virus had reached pandemic proportions; rapid implementation of large-scale immunization programmes was considered essential to reduce the burden of disease
We believe that the media and internet contributed to this problem by raising concerns within the general population and that failure to involve general practitioners (GPs) in the control programme may have been a mistake
The top-down strategy of vaccine programme management and information delivered by the Ministry of Health could have aggravated the problem, because the general population does not always trust politicians

Summary

Introduction

Following the confirmation by the World Health Organization, that A/H1N1 influenza virus had reached pandemic proportions; rapid implementation of large-scale immunization programmes was considered essential to reduce the burden of disease. It has been demonstrated that influenza vaccination of widely different human categories, for example, healthy adults of all ages [3], children [5] or high risk populations such as the elderly [1,4] may have a significant impact on hospitalization rate, influenza associated mortality, global morbidity and mortality. In France, there was a reluctance to accept vaccination against the A/H1N1 pandemic influenza virus despite government recommendation and investment in the vaccine programme

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Discussion

Conclusion