Silva Maria Laura, Perrier Lionel, Cohen Jean Marie, Paget William John, Mosnier Anne, Späth Hans Martin
Université Lumière Lyon 2, Lyon F-69007, France; CNRS, GATE Lyon Saint-Etienne, Ecully F-69130, France.
Université Lumière Lyon 2, Lyon F-69007, France; CNRS, GATE Lyon Saint-Etienne, Ecully F-69130, France; Direction of Clinical Research and Innovation, DRCI, Léon Bérard Cancer Centre, Lyon, France.
Health Policy. 2015 Jun;119(6):697-708. doi: 10.1016/j.healthpol.2015.04.006. Epub 2015 Apr 20.
To conduct a literature review of influenza vaccination policy, describing roles and interactions between stakeholders and the factors influencing policy-making.
Major databases were searched using keywords related to influenza vaccination, decision-making and health policy. Titles and abstracts were screened according to defined criteria using independent reviewers. Selected articles were analysed and compared against a checklist.
342 papers were identified, but only 111 included. A wide range of countries was represented in articles published in 1994-2012. We identified numerous stakeholders at the national and international level and found a variety of interactions between them. Using these data, we suggest a scheme for the most important stakeholders and their interactions. Determinants of policy-making were mainly related to the vaccine/disease, political-economic context, and stakeholders communication. The most relevant evidence was clinical/epidemiological studies. After the 2009 pandemic: the importance of mathematical modelling and ethical issues was greater; and the need for better communication between stakeholders was emphasised.
The relevance of evidence and factors influencing policy-making varied between countries, according to complex interactions between the stakeholders involved at different levels of decision-making process. These interactions remain unclear, especially at national level, where the most important influenza policy decisions are made. To better define and understand the exact interactions and use of evidence, we recommend undertaking future qualitative studies at national level using small number of countries.
对流感疫苗接种政策进行文献综述，描述利益相关者之间的角色和互动以及影响政策制定的因素。
使用与流感疫苗接种、决策制定和卫生政策相关的关键词搜索主要数据库。由独立评审人员根据既定标准筛选标题和摘要。对选定的文章进行分析，并对照清单进行比较。
共识别出342篇论文，但仅纳入111篇。1994年至2012年发表的文章涵盖了广泛的国家。我们确定了国家和国际层面的众多利益相关者，并发现了他们之间的各种互动。利用这些数据，我们提出了一个关于最重要利益相关者及其互动的方案。政策制定的决定因素主要与疫苗/疾病、政治经济背景以及利益相关者之间的沟通有关。最相关的证据是临床/流行病学研究。2009年大流行之后：数学建模和伦理问题的重要性增加；强调了利益相关者之间加强沟通的必要性。
根据不同决策层面利益相关者之间复杂的相互作用，证据和影响政策制定的因素在不同国家之间存在差异。这些相互作用仍不明确，尤其是在做出最重要流感政策决策的国家层面。为了更好地界定和理解确切的相互作用以及证据的使用，我们建议未来在少数国家的国家层面开展定性研究。
