Factors associated with vaccination for hepatitis B, pertussis, seasonal and pandemic influenza among French general practitioners: A 2010 survey
Introduction
Vaccination protects general practitioners (GPs) against an occupational risk by providing individual protection and they also limit absenteeism. Additionally, they prevent transmission to the patients and therefore have a crucial role in preventing healthcare-acquired infections. In France, vaccination guidelines targeted to healthcare professionals distinguish two types of recommendations: mandatory vaccinations such as hepatitis B since 1991, and recommended vaccinations, such as annual seasonal influenza since 2000, pertussis since 2004 and pandemic A/H1N1 influenza in 2009. Several studies have shown that GPs who receive immunisation are more likely to recommend it more strongly to their patients [1], [2], [3], [4]. Data on GPs’ vaccine coverage (VC) are therefore useful, and identifying the determinants of VC is needed for guiding national and regional policy in order to improve VC both for GPs and their patients. Many studies have been published on this topic for hospital healthcare workers. However, relatively few studies have been published on this topic for GPs in France [1] or elsewhere [2], [5], [6], [7], [8], [9], [10], with most of these studies targeting only influenza [2], [5], [7], [8], [9], [10].
Using a representative national panel of 1431 self-employed GPs in France, our objectives were to describe the self-reported VC for hepatitis B, pertussis, seasonal and pandemic influenza and to study the factors associated with being vaccinated against each of these four diseases.
Section snippets
Sampling
A panel of French GPs was constituted in June 2010. 5170 GPs were selected by random sampling from ADELI (“Automatisation DEs LIstes”), the Ministry of Health's exhaustive database of health professionals in France. Sampling was stratified for location of the general practice (urban, peri-urban, or rural areas), gender, age (<49, 49–56, >56 years old) and workload, defined by number of consultations (<2849, 2849–5494, >5494) in 2008 (information obtained for each GP from the exhaustive
GPs’ characteristics
All the 1431 GPs who joined the panel participated in this cross-sectional survey. Their demographic and professional characteristics are reported in Table 1.
GPs’ vaccine coverage rates
VC was 76.9% and 78.1% for seasonal flu in 2009/10 and 2008/09, respectively, 73.0% for hepatitis B, and 63.9% for pertussis; 60.8% of the panel reported vaccination against pandemic A/H1N1 2009 flu. Only 30.4% of the panel declared being up-to-date for all four vaccines.
Factors associated with vaccine coverage
The results of the multivariate Poisson regression models with a
Discussion
In this panel of GPs, reported vaccine coverage for occupational vaccines was quite high: 76.9% for 2009/10 seasonal flu, 73.0% for hepatitis B, 63.9% for pertussis and 60.8% for pandemic A/H1N1 2009 flu. Many factors associated with being vaccinated could be identified, quite specific to each vaccine and showing regional variations of VC for pertussis vaccine and all four vaccines. All these findings suggest that GPs have different attitudes towards each of the vaccines studied in this
Funding
The French Panel of General Practices received funding from Direction de la Recherche, des Etudes, de l’Evaluation et des Statistiques (DREES) – Ministère du travail, des relations sociales, de la famille, de la solidarité et de la ville, Ministère de la santé et des sports, through a multiannual agreement on objectives. The work of C.P. was supported by the “Infectiopole Sud” foundation (a non profit-making foundation, http://www.infectiopolesud.com/), which paid for her accommodation and
Acknowledgements
We thank all GPs who participated to the survey as well as members of the supervisory committee of the French Panel of General Practices. We are grateful to Jean-Paul Guthmann and to Bérengère Davin for their helpful comments.
Contributors: C.P. designed the study and wrote the article. S.M. performed the statistical analysis. S.M., O.L. and P.V. reviewed the study protocol and the article. Conflict of interest statement: All authors declare no conflict of interest.
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