Joseph J-P, Staffolani F, Kinouani S, Broussy S, Picat M-Q, Senand B, Ducos G
Département de médecine générale, université de Bordeaux, 146, rue Léo-Saignat, 33076 Bordeaux Cedex, France.
Département de médecine générale, université de Bordeaux, 146, rue Léo-Saignat, 33076 Bordeaux Cedex, France.
Rev Epidemiol Sante Publique. 2014 Oct;62(5):291-6. doi: 10.1016/j.respe.2014.07.003. Epub 2014 Oct 16.
In France, vaccination coverage against seasonal influenza for risk groups was inadequate: 55.2% of people aged 65 and older, and 33% of the 16-64 year group with chronic targeted disorders were vaccinated in March 2012. Three quarters of general practitioners were vaccinated. Our objective was to estimate the influence of the vaccination status of general practitioners on vaccine coverage of their patients at risk.
A questionnaire was sent in March 2012 to a sample of 500 general practitioners. Their professional characteristics, vaccination status against seasonal influenza and the determinants of these vaccinations were collected and compared to the vaccine coverage of their patients obtained from the French healthcare fund.
Self-reported vaccination coverage of the 225 general practitioners respondents was 81.3%. There was a positive correlation with age greater than 50 years, high activity level, rural practice and the absence of particular mode of exercise. The doctors wanted to be vaccinated to protect themselves and protect their patients or their family. Of the 42 doctors unvaccinated, 42.5% feared the side effects of the vaccine, 40% considered influenza to be a benign illness and 32.5% considered low risk of catching or spreading it. The vaccination rate for patients aged 65 and older was 62.3% among 147 doctors vaccinated versus 58.3% in unvaccinated 31 physicians (P<0.0001). These rates were 39% versus 36.7% (P=0.29) for patients with chronic targeted disorders.
This study shows a positive association between the reported vaccination of general practitioners and effective influenza vaccination of their patients aged 65 years and older. This result is less clear for patients with chronic targeted disorders. All this findings argue in favor of promoting seasonal influenza vaccination among general practitioners.
在法国,针对高危人群的季节性流感疫苗接种覆盖率不足:2012年3月,65岁及以上人群中有55.2%接种了疫苗,患有慢性特定疾病的16 - 64岁人群中有33%接种了疫苗。四分之三的全科医生接种了疫苗。我们的目标是评估全科医生的疫苗接种状况对其高危患者疫苗接种覆盖率的影响。
2012年3月向500名全科医生的样本发送了一份问卷。收集了他们的专业特征、针对季节性流感的疫苗接种状况以及这些接种的决定因素,并与从法国医疗保健基金获得的其患者的疫苗接种覆盖率进行比较。
225名回复问卷的全科医生自我报告的疫苗接种覆盖率为81.3%。与年龄大于50岁、高活动水平、在农村执业以及没有特定运动方式呈正相关。医生希望接种疫苗以保护自己、保护患者或家人。在42名未接种疫苗的医生中,42.5%担心疫苗的副作用,40%认为流感是一种良性疾病,32.5%认为感染或传播流感的风险较低。在147名接种疫苗的医生中,65岁及以上患者的疫苗接种率为62.3%,而在31名未接种疫苗的医生中为58.3%(P<0.0001)。对于患有慢性特定疾病的患者,这些比率分别为39%和36.7%(P = 0.29)。
本研究表明,全科医生报告的疫苗接种与他们65岁及以上患者的有效流感疫苗接种之间存在正相关。对于患有慢性特定疾病的患者,这一结果不太明确。所有这些发现都支持在全科医生中推广季节性流感疫苗接种。