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法国医生如何应对婴儿白喉、破伤风、百日咳和脊髓灰质炎基础免疫接种未来可能发生的变化?一项采用焦点小组的定性研究。

How French physicians manage with a future change in the primary vaccination of infants against diphtheria, tetanus, pertussis and poliomyelitis? A qualitative study with focus groups.

机构信息

INSERM U707, 27, rue Chaligny, Paris F-75012, France.

出版信息

BMC Fam Pract. 2013 Jun 19;14:85. doi: 10.1186/1471-2296-14-85.

Abstract

BACKGROUND

As in other European countries, the French vaccination schedule changes according to epidemiological and socio-economic situations. Further changes are planned for 2013, including the withdrawal of one dose for primary vaccination against diphtheria, tetanus, polio, pertussis and Haemophilus influenzae. A partnership between the French Technical Vaccination Committee and the French Institute for Health and Medical Research designed a study to assess primary care physicians' agreement about this modification.

METHODS

Qualitative study with focus groups and semi-structured interviews in France. Four focus groups were conducted with physicians, supplemented by four individual interviews.

RESULTS

The physicians of the survey had accepted the suggested vaccination schedule well. A few concerns had been underlined: fear of less follow-up care for infants resulting from the removal of one visit driven by the primary vaccination; fear of loss of vaccine efficacy; suspicion of the existence of financial arguments at the origin of this change; and adjustment to current vaccination schedule. Several suggestions were made: providing strong support from health authorities; developing stable and simple recommendations; providing effective tools for monitoring patient's vaccination status.

CONCLUSIONS

Physicians' opinions suggested a good acceptance of a possible change about primary vaccination against diphtheria, tetanus, polio, pertussis and Haemophilus influenzae. Physicians' suggestions resulted from this qualitative study on a new vaccination schedule. It showed how that their involvement was feasible for preparing the implementation of a new vaccination schedule.

摘要

背景

与其他欧洲国家一样,法国的疫苗接种计划会根据流行病学和社会经济情况而变化。2013 年还计划进行进一步的调整,包括取消一剂针对白喉、破伤风、脊髓灰质炎、百日咳和流感嗜血杆菌的基础免疫。法国技术疫苗委员会与法国健康与医学研究所合作,设计了一项研究,以评估初级保健医生对这一修改的意见。

方法

在法国进行了一项定性研究,包括焦点小组和半结构化访谈。共进行了 4 个焦点小组,另外还进行了 4 个个体访谈。

结果

参与调查的医生对建议的疫苗接种计划接受良好。强调了一些关注:担心由于取消了一次由基础免疫驱动的就诊,婴儿的后续护理会减少;担心疫苗效力的丧失;怀疑这种变化的起源存在经济方面的考虑;以及适应当前的疫苗接种计划。提出了一些建议:提供来自卫生当局的大力支持;制定稳定和简单的建议;提供有效的工具来监测患者的疫苗接种状况。

结论

医生的意见表明,他们可能会接受对白喉、破伤风、脊髓灰质炎、百日咳和流感嗜血杆菌的基础免疫的改变。医生的建议是基于对新疫苗接种计划的这项定性研究得出的。它表明,他们的参与对于准备实施新的疫苗接种计划是可行的。

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Childhood vaccination schedules in Europe vary widely. Is this a problem?
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2009 Nov;52(11):1095-8. doi: 10.1007/s00103-009-0960-z.

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