IAME (Infection, Antimicrobien, Modélisation, Evolution), UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France; Département de Biostatistique et Information Médicale, UMR-S717, Hôpital Saint Louis, APHP, Paris, France.
Université Nice-Sophia Antipolis, Faculté de Médecine de Nice, Nice, France; CHU de Nice, Service d'Infectiologie, Nice, France; Aix Marseille Université (Aix Marseille School of Economics-SESSTIM UMR 912, INSERM, IRD), Marseille, France.
Vaccine. 2014 Apr 25;32(20):2281-7. doi: 10.1016/j.vaccine.2014.02.074. Epub 2014 Mar 12.
General practitioners' (GPs) recommendations to their patients regarding influenza vaccination is a key determinant of patient uptake of influenza vaccination.
To study factors associated with GPs' recommendations regarding pandemic vaccination (pvaccination) to adults ≤65 years of age (hereafter referred to as adults) at risk and not at risk of severe complications of the 2009-2010 A/H1N1 influenza.
PATIENTS/METHODS: National cross-sectional survey of 1431 French GPs. Pvaccination recommendations by GPs to adults were studied according to three categories: recommended pvaccination to at-risk adults only; recommended pvaccination to all adults; recommended against pvaccination or did not provide any advice to any adult.
GPs were more likely to recommend pvaccination to at-risk than not-at-risk adults (73.4% vs 40.1%, p<0.01). GPs who consulted official sources of information rather than news media during the pandemic were more likely to recommend pvaccination to at-risk adults only (OR=1.78; CI 95%=1.27-2.48) and to all adults (OR=2.03; CI 95%=1.42-2.92) than other GPs. GPs' unfavorable perceptions of the risk/efficacy balance of the pandemic vaccine (pvaccine) together with their perceptions of the low severity of the disease were negatively associated with recommending pvaccination. Hospitalization of GPs' patients because of the influenza was specifically associated with pvaccine recommendation to all adults (OR=2.81; CI 95%=1.98-3.99) but not with pvaccine recommendation to at-risk adults only.
In the pandemic context, GPs' perceptions of disease severity and the risk/efficacy balance of the pvaccine were the major determinants of French GPs recommending pvaccination or not. To increase the general public's acceptability of vaccination policies, GPs should be adequately informed about the course of the epidemics and the safety of the vaccine.
全科医生（GP）向患者推荐流感疫苗接种是决定患者是否接受流感疫苗接种的关键因素。
研究与全科医生向有或无严重 2009-2010 年 A/H1N1 流感并发症风险的≤65 岁成人推荐大流行性流感疫苗接种（pvaccination）相关的因素。
患者/方法：对 1431 名法国全科医生进行全国性横断面调查。根据三个类别研究全科医生向成人推荐 pvaccination 的情况：仅向有风险的成人推荐 pvaccination；向所有成人推荐 pvaccination；向任何成人推荐不接种疫苗或不提供任何建议。
全科医生更倾向于向有风险的成人而不是无风险的成人推荐 pvaccination（73.4%对 40.1%，p<0.01）。在大流行期间，与仅咨询新闻媒体相比，更倾向于咨询官方信息来源的全科医生更有可能仅向有风险的成人（OR=1.78；95%置信区间[CI]95%=1.27-2.48）和所有成人（OR=2.03；95%CI 95%=1.42-2.92）推荐 pvaccination。全科医生对大流行疫苗（pvaccine）风险/疗效平衡的不利看法以及他们对疾病严重程度的看法与推荐 pvaccination 呈负相关。全科医生的患者因流感住院与向所有成人推荐 pvaccine 特别相关（OR=2.81；95%CI 95%=1.98-3.99），而与仅向有风险的成人推荐 pvaccine 无关。
在大流行背景下，全科医生对疾病严重程度和 pvaccine 风险/疗效平衡的看法是决定法国全科医生是否推荐 pvaccination 的主要因素。为了提高公众对疫苗接种政策的接受度，应向全科医生充分告知疫情的发展和疫苗的安全性。
