Te Linde Elsemieke, Doornekamp Laura, Daenen Katrijn C P, van Gorp Eric C M, Bruns Anke H W
Department of Infectious Diseases, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.
Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands.
Vaccines (Basel). 2023 Mar 17;11(3):686. doi: 10.3390/vaccines11030686.
Specific vaccines are indicated for immunocompromised patients (ICPs) due to their vulnerability to infections. Recommendation of these vaccines by healthcare professionals (HCPs) is a crucial facilitator for vaccine uptake. Unfortunately, the responsibilities to recommend and administer these vaccines are not clearly allocated among HCPs involved in the care of adult ICPs. We aimed to evaluate HCPs' opinions on directorship and their role in facilitating the uptake of medically indicated vaccines as a basis to improve vaccination practices.
A cross-sectional survey was performed among in-hospital medical specialists (MSs), general practitioners (GPs), and public health specialists (PHSs) in the Netherlands to assess their opinion on directorship and the implementation of vaccination care. Additionally, perceived barriers, facilitators, and possible solutions to improve vaccine uptake were investigated.
In total, 306 HCPs completed the survey. HCPs almost unanimously (98%) reported that according to them, the primary treating physician is responsible for recommending medically indicated vaccines. Administering these vaccines was seen as a more shared responsibility. The most important barriers experienced by HCPs in recommending and administering were reimbursement problems, a lack of a national vaccination registration system, insufficient collaboration among HCPs, and logistical problems. MSs, GPs and PHSs all mentioned the same three solutions as important strategies to improve vaccination practices, i.e., reimbursement of vaccines, reliable and easily accessible registration of received vaccines, and arrangements for collaboration among the different HCPs that are involved in care.
The improvement in vaccination practices in ICPs should focus on better collaboration among MSs, GPs, and PHSs, who should know each other's expertise; clear agreement on responsibility; reimbursement for vaccines; and the availability of clear registration of vaccination history.
免疫功能低下患者（ICPs）因易受感染而需要接种特定疫苗。医疗保健专业人员（HCPs）对这些疫苗的推荐是促进疫苗接种的关键因素。不幸的是，在成年ICPs护理中涉及的HCPs之间，推荐和接种这些疫苗的责任并未明确划分。我们旨在评估HCPs对指导权的看法及其在促进接种医学指示疫苗方面的作用，以此作为改进疫苗接种实践的基础。
在荷兰对住院医学专家（MSs）、全科医生（GPs）和公共卫生专家（PHSs）进行了一项横断面调查，以评估他们对指导权和疫苗接种护理实施的看法。此外，还调查了提高疫苗接种率的感知障碍、促进因素和可能的解决方案。
共有306名HCPs完成了调查。HCPs几乎一致（98%）报告称，在他们看来，主要治疗医生负责推荐医学指示疫苗。接种这些疫苗被视为一项更具共享性的责任。HCPs在推荐和接种过程中遇到的最重要障碍包括报销问题、缺乏国家疫苗接种登记系统、HCPs之间协作不足以及后勤问题。MSs、GPs和PHSs都提到了相同的三个解决方案，认为这是改进疫苗接种实践的重要策略，即疫苗报销、对接种疫苗进行可靠且易于获取的登记以及安排参与护理的不同HCPs之间的协作。
改善ICPs的疫苗接种实践应侧重于MSs、GPs和PHSs之间更好的协作，他们应了解彼此的专业知识；明确责任分工；疫苗报销；以及提供清晰的疫苗接种历史登记。
