Wong Anabelle, Opinel Annick, Combes Simon Jean-Baptiste, Toubiana Julie, Brisse Sylvain
Institut Pasteur/INSERM/University of Versailles Saint Quentin, UMR 1181 Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases, 25 rue du Dr Roux, F-75724 Paris CEDEX 15, France.
EHESP French School of Public Health, F-35000 Rennes, France.
Vaccines (Basel). 2020 Jan 26;8(1):46. doi: 10.3390/vaccines8010046.
Pertussis vaccination policy varies across Europe, not only in the type of vaccine-whole cell (wP) vs. acellular (aP1/2/3/5)-but also in the schedule and recommendation for parents. This study aims to investigate the determining factors for the type of vaccine, immunization schedule and maternal immunization recommendation. From March to May 2019, experts in national health agencies and major academic or research institutions from Denmark, France, Poland, Sweden and the UK were invited to a semi-structured interview. Thematic analysis was performed on the transcripts using a codebook formulated by three coders. Inter-coder agreement was assessed. Fifteen expert interviews were conducted. The identified driving factors for pertussis vaccine policy were classified into three domains: scientific factors, sociological factors, and pragmatic factors. The determining factors for the type of vaccine were prescriber's preference, concern of adverse events following immunization (AEFI), effectiveness, and consideration of other vaccine components in combined vaccines. The determining factors for infant schedule were immunity response and the potential to improve coverage and timeliness. The determining factors for maternal immunization were infant mortality and public acceptability. To conclude, socio-political and pragmatic factors were, besides scientific factors, important in determining the pertussis vaccine type, schedule of childhood immunization and recommendations for parents.
百日咳疫苗接种政策在欧洲各国有所不同，不仅体现在疫苗类型（全细胞疫苗（wP）与无细胞疫苗（aP1/2/3/5））上，还体现在接种计划和对家长的建议方面。本研究旨在调查疫苗类型、免疫接种计划和产妇免疫接种建议的决定因素。2019年3月至5月，邀请了丹麦、法国、波兰、瑞典和英国国家卫生机构以及主要学术或研究机构的专家参加半结构化访谈。使用由三名编码员制定的编码手册对访谈记录进行主题分析。评估了编码员之间的一致性。共进行了15次专家访谈。确定的百日咳疫苗政策驱动因素分为三个领域：科学因素、社会因素和实用因素。疫苗类型的决定因素包括开处方者的偏好、对免疫接种后不良事件（AEFI）的担忧、有效性以及联合疫苗中对其他疫苗成分的考虑。婴儿接种计划的决定因素是免疫反应以及提高覆盖率和及时性的潜力。产妇免疫接种的决定因素是婴儿死亡率和公众可接受性。总之，除科学因素外，社会政治和实用因素在决定百日咳疫苗类型、儿童免疫接种计划和对家长的建议方面也很重要。
