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.
Highlights
In March, 2009, a new influenza virus, A(H1N1), appeared in Mexico and rapidly spread to several countries [1]
All general practitioners (GPs) who initially joined the panel participated in this crosssectional survey: 72.7% were male, 30.9% younger than 49 years, and 36.5% aged 49–56 years; 53.5% were in group practices; 52.9% had 2849–5494 individual patient visits in 2008; 81.2% had been vaccinated against seasonal influenza at least once between 2007 and 2009, and 71.5% in all three of those years (Table 1)
According to 51.9% of the participants the severity of the pandemic was low; 32.7% thought the side effects of the pvaccine were a matter of serious concern, and 45.3% that there was a lack of reliable efficacy data; 57.6% did not trust the health authorities’ ability to manage the pandemic. These percentages were significantly lower among GPs who had been vaccinated against seasonal influenza each year in 2007–2009 than in GPs not vaccinated at all
Summary
In March, 2009, a new influenza virus, A(H1N1), appeared in Mexico and rapidly spread to several countries [1]. In July, French health authorities, like those in many other countries, decided to follow the WHO recommendation [2] and embark on a mass vaccination campaign against the pandemic influenza. French authorities organized this campaign in dedicated centers and did not involve private general practitioners (GPs), who normally deliver most vaccinations against seasonal influenza. The reasons for this decision were the multidose presentation of the vaccine and to facilitate monitoring of pandemic vaccination (pvaccination) coverage. 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
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