Szucs Thomas D, Wahle Klaus, Müller Daniela
Institut für Sozial- und Präventivmedizin, Universität Zürich, Schweiz.
Med Klin (Munich). 2006 Jul 15;101(7):537-45. doi: 10.1007/s00063-006-1076-y.
Influenza represents a considerable worldwide health problem. Vaccination is the only preventive measure, capable of reducing mortality and morbidity of influenza in all age groups. The objective of this study was to assess the extent of influenza vaccination coverage in the seasons 2002/2003, 2003/2004 and 2004/2005 in Germany, to understand the driving forces and barriers to vaccination, and to determine vaccination intentions for the subsequent winter.
The authors conducted a random-sampling, telephone-based household survey among noninstitutionalized individuals representative of the population aged > or =14. The surveys for the different seasons used the same questionnaire and were subsequently pooled. Four target groups were determined for analysis: (1) persons aged > or =60; (2) people working in the medical field; (3) persons suffering from chronic illness; and (4) a composite group made up of persons aged > or =60 or working in the medical field or suffering from a chronic illness.
The overall sample consisted of 5,990 people. The influenza vaccination coverage rate in Germany increased from 22.3% in season 2002/2003 to 25.1% in season 2003/2004 and increased again to 26.5% in season 2004/2005. This increase is statistically significant (p = 0.007). The composite group coverage rate increased from 40.0% (2002/2003) to 42.2% (2004/2005). The driving forces and barriers to vaccination did not change over the years. The most frequent reasons for being vaccinated given by vaccinees were: influenza considered to be a serious illness which people wanted to avoid, having received advice from the family doctor or nurse to be vaccinated, and not wanting to infect family and friends. Reasons for not being vaccinated mentioned by people who have never been vaccinated were: thinking about it, however, not being vaccinated in the end, not expecting to catch influenza, and not having received a recommendation from the family doctor to be vaccinated. Major encouraging factors to influenza vaccination were: recommendation by the family doctor or nurse, more available information on the vaccine regarding efficacy and tolerance, and more information available about the disease.
The vaccination coverage rate increased by 4.2% over the three seasons. The family doctor is the most important source of encouragement for people to be vaccinated against influenza. It seems that the public would be more likely to be vaccinated if they had more information on the efficacy and tolerance of the vaccine, as well as the disease. The authors therefore suggest that family doctors be better informed on influenza vaccine and the disease itself, so that they can actively inform their patients on these topics.
流感是一个全球性的重大健康问题。接种疫苗是唯一能够降低各年龄组流感死亡率和发病率的预防措施。本研究的目的是评估2002/2003、2003/2004和2004/2005季节德国流感疫苗接种的覆盖范围，了解疫苗接种的驱动因素和障碍，并确定下一个冬季的接种意愿。
作者对年龄≥14岁的非住院人群进行了一项基于电话的随机抽样家庭调查。不同季节的调查使用相同的问卷，随后进行汇总。确定了四个目标组进行分析：（1）年龄≥60岁的人群；（2）从事医疗领域工作的人员；（3）患有慢性病的人员；（4）由年龄≥60岁、从事医疗领域工作或患有慢性病的人员组成的综合组。
总样本包括5990人。德国流感疫苗接种覆盖率从2002/2003季节的22.3%增至2003/2004季节的25.1%，并在2004/2005季节再次增至26.5%。这种增长具有统计学意义（p = 0.007）。综合组的覆盖率从40.0%（2002/2003）增至42.2%（2004/2005）。多年来，疫苗接种的驱动因素和障碍没有变化。接种者接种疫苗最常见的原因是：认为流感是一种严重疾病，人们希望避免感染；听从家庭医生或护士的建议接种疫苗；不想感染家人和朋友。从未接种过疫苗的人提到不接种的原因是：考虑过接种，但最终没有接种；不认为自己会感染流感；没有得到家庭医生的接种建议。鼓励接种流感疫苗的主要因素包括：家庭医生或护士的建议；有更多关于疫苗效力和耐受性的信息；有更多关于该疾病的信息。
三个季节的疫苗接种覆盖率提高了4.2%。家庭医生是鼓励人们接种流感疫苗的最重要来源。如果公众能获得更多关于疫苗效力和耐受性以及该疾病的信息，他们似乎更有可能接种疫苗。因此，作者建议让家庭医生更好地了解流感疫苗和疾病本身，以便他们能够积极向患者宣传这些话题。
