INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 23 rue Stanislas Torrents, 13006 Marseille, France ; ORS PACA, Southeastern Health Regional Observatory, 23 rue Stanislas Torrents, 13006 Marseille, France ; Aix Marseille University, IRD, UMR-S912, 58 bd Charles Livon, 13284 Marseille Cedex 07, France ; INSERM, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), GH Cochin Broca Hôtel Dieu, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France.
INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 23 rue Stanislas Torrents, 13006 Marseille, France ; ORS PACA, Southeastern Health Regional Observatory, 23 rue Stanislas Torrents, 13006 Marseille, France ; Aix Marseille University, IRD, UMR-S912, 58 bd Charles Livon, 13284 Marseille Cedex 07, France.
EBioMedicine. 2015 Jun 23;2(8):891-7. doi: 10.1016/j.ebiom.2015.06.018. eCollection 2015 Aug.
This study aimed to assess: 1) vaccine hesitancy (VH) prevalence among French general practitioners (GPs) through the frequency of their vaccine recommendations, and 2) the determinants of these recommendations.
Cross-sectional observational study in 2014 nested in a national panel of 1712 randomly selected GPs in private practice in France. We constructed a score of self-reported recommendation frequency for 6 specific vaccines to target populations.
16% to 43% of GPs sometimes or never recommended at least one specific vaccine to their target patients. Multivariable logistic regressions of the dichotomized score showed that GPs recommended vaccines frequently when they felt comfortable explaining their benefits and risks to patients (OR = 1.87; 1.35-2.59), or trusted official sources of information highly (OR = 1.40; 1.01-1.93). They recommended vaccines infrequently when they considered that adverse effects were likely (OR = 0.71; 0.52-0.96) or doubted the vaccine's utility (OR = 0.21; 0.15-0.29).
Our findings show that after repeated vaccine controversies in France, some VH exists among French GPs, whose recommendation behaviors depend on their trust in authorities, their perception of the utility and risks of vaccines, and their comfort in explaining them. Further research is needed to confirm these results among health care workers in other countries.
本研究旨在评估：1）通过疫苗推荐频率评估法国全科医生（GP）的疫苗犹豫（VH）发生率，2）这些建议的决定因素。
2014 年，在法国进行了一项横断面观察性研究，纳入了一个由 1712 名随机选择的私人执业全科医生组成的全国小组。我们构建了针对目标人群的 6 种特定疫苗的自我报告推荐频率评分。
16%至 43%的 GP 有时或从不向其目标患者推荐至少一种特定疫苗。对二分评分进行的多变量逻辑回归显示，当 GP 对向患者解释疫苗的益处和风险感到舒适时（OR=1.87；1.35-2.59），或非常信任官方信息来源时（OR=1.40；1.01-1.93），他们会频繁推荐疫苗。当他们认为可能会产生不良反应（OR=0.71；0.52-0.96）或怀疑疫苗的效用时（OR=0.21；0.15-0.29），他们推荐疫苗的频率较低。
我们的研究结果表明，在法国多次出现疫苗争议后，一些 VH 确实存在于法国 GP 中，他们的推荐行为取决于他们对权威的信任、对疫苗效用和风险的看法，以及他们解释这些疫苗的舒适度。需要进一步研究来确认这些结果在其他国家的卫生保健工作者中的存在。
