Elsevier

Vaccine

Volume 31, Issue 37, 20 August 2013, Pages 3943-3949
Vaccine

Factors associated with vaccination for hepatitis B, pertussis, seasonal and pandemic influenza among French general practitioners: A 2010 survey

https://doi.org/10.1016/j.vaccine.2013.06.039Get rights and content

Highlights

  • Vaccine coverage was insufficient among French general practitioners.

  • The factors associated with being vaccinated were different from one vaccine to another.

  • Being vaccinated for one vaccine increased the vaccine coverage for the other vaccines.

Abstract

Our objectives were to describe the vaccine coverage (VC1) for some occupational vaccines (hepatitis B, pertussis, seasonal and pandemic influenza) among French General Practitioners (GPs2) and to study the factors associated with being vaccinated for each of these four diseases. We surveyed a representative national sample of 1431 self-employed GPs in France. Self-reported VC was 76.9% for 2009/10 seasonal influenza, 73.0% for hepatitis B, 63.9% for pertussis and 60.8% for A/H1N1 pandemic influenza. The factors associated with reporting being vaccinated were quite different from one vaccine to another. For some or all four vaccines, we found a significant positive association (p < 0.05) with the following factors in the multivariate analysis: GP's male gender, high volume of activity, no particular mode of exercise (e.g. homoeopathy), no use of Internet at the practice, Continuing Medical Education sessions, discussing the benefits and risks of vaccination with the patients and performing prevention investigations for oneself (lipid profile). Being vaccinated for one vaccine also increased the VC for some or all three other studied vaccines. All these findings argue for public health campaigns using messages adapted to each vaccine.

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.

References (34)

Cited by (59)

  • Predictors of poor serologic response to COVID-19 vaccine in patients with cancer: a systematic review and meta-analysis

    2022, European Journal of Cancer
    Citation Excerpt :

    The present study found advanced age with increased negative seroconversion to COVID-19 vaccine may due to the unresponsiveness of immune system at older age. Females develop higher antibody responses to vaccines than males [59]. After vaccination, protective antibody responses can be twice as high in adult females than in males [60].

  • The psychological and behavioural correlates of COVID-19 vaccine hesitancy and resistance in Ireland and the UK

    2022, Acta Psychologica
    Citation Excerpt :

    Results from independent non-parametric tests from both samples suggest that those who were vaccine hesitant had a significantly younger age than both the vaccine resistant and vaccine accepting groups. Distinctions in intention to vaccinate against COVID-19 based on age and gender have been seen in several other similar studies (Callaghan et al., 2021; Murphy et al., 2021); as well as in research examining intention to vaccinate against other infectious diseases (Flanagan et al., 2017; Pulcini et al., 2013). Regression modelling of the overall sample (UK and Ireland), identified that those who were vaccine hesitant had more negative attitudes towards vaccination, had an increased rate of perceived COVID-19 severity, and were less likely to be influenced by their government.

  • Hesitancy in the time of coronavirus: Temporal, spatial, and sociodemographic variations in COVID-19 vaccine hesitancy

    2021, SSM - Population Health
    Citation Excerpt :

    Third, our findings point to important gender differences as well. Consistent with previous evidence on gender differences in vaccination behaviors and attitudes (e.g., Callaghan et al., 2021; Flanagan et al., 2017; Latkin et al., 2021; Pulcini et al., 2013), we observe a higher level of overall vaccine hesitancy among women than men in early periods. However, when examining different dimensions of vaccine hesitancy, our findings point out that women are more likely to develop hesitancy due to circumspection, and this kind of hesitancy declines faster than hesitancy due to confidence and complacency.

View all citing articles on Scopus
1

VC: Vaccine coverage.

2

GPs: General practitioners.

View full text