Université de Lorraine, EA 4360 APEMAC, Nancy, France; INSERM, CIC-1433 Epidémiologie clinique, CHRU de Nancy, Nancy, France.
Université de Lorraine, EA 4360 APEMAC, Nancy, France.
Clin Microbiol Infect. 2017 May;23(5):311-317. doi: 10.1016/j.cmi.2016.08.019. Epub 2016 Sep 4.
The objectives of our study were to describe the vaccination recommendations by general practitioners (GPs) for their patients and practices for their children, and to identify any discrepancies between them.
Applying multiple correspondence analysis and agglomerative hierarchical cluster analysis to data from a 2014 cross-sectional survey of a national sample of GPs, we constructed a typology based on the patterns of associations between GPs' vaccine recommendations to their patients and practices to their own children's vaccinations.
This study includes the 1038 GPs who reported that they had at least one child aged 2-25 years. Nearly half (47%, 482/1021) reported that all of their children were vaccinated against hepatitis B but that they did not always recommend that vaccine to patients; the same discordance was observed among 36% (369/1027) for the measles-mumps-rubella vaccine, 19% (194/1013) to 28% (290/1019) for routine and catch-up meningococcal C vaccination, and 27% (136/496) for the human papillomavirus vaccine. Cluster analysis showed that 37% (95% CI 33%-39%) of GPs reported an above-average rate of systematic vaccine recommendations for their patients, and most reported that all their children were vaccinated (low level of discordance), whereas 60% (95% CI 58%-64%) had a high level of discordance, that is, most reported that their children were vaccinated, but did not always recommend the same vaccines to their patients.
Many GPs do not report the same attitude concerning the vaccination of their children and their patients. The reasons underlying these discrepancies, possibly including vaccine hesitancy, should be investigated.
本研究的目的是描述全科医生(GP)对其患者和自身子女的疫苗接种建议,并确定两者之间的差异。
我们应用多元对应分析和凝聚层次聚类分析方法,对 2014 年一项全国性 GP 横断面调查的数据进行分析,基于 GP 对患者和自身子女疫苗接种建议模式之间的关联,构建了一种分类法。
本研究共纳入 1038 名报告至少有一名 2-25 岁子女的 GP。近一半(47%,482/1021)报告称他们所有的孩子都接种了乙型肝炎疫苗,但他们并不总是向患者推荐该疫苗;同样的不一致性也出现在麻疹-腮腺炎-风疹疫苗中(36%,369/1027)、常规和查漏补种脑膜炎球菌 C 疫苗中(19%,194/1013)至 28%(290/1019)和人乳头瘤病毒疫苗中(27%,136/496)。聚类分析显示,37%(95%CI 33%-39%)的 GP 报告对患者有较高的系统疫苗推荐率,且大多数报告称他们所有的孩子都接种了疫苗(差异程度较低),而 60%(95%CI 58%-64%)差异程度较高,即大多数报告称他们的孩子接种了疫苗,但并不总是向患者推荐相同的疫苗。
许多 GP 对其子女和患者的疫苗接种态度不一致。这些差异的原因可能包括疫苗犹豫,应进行调查。