Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece; Research Committee of Greek Association of General Practitioners, Greece.
Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.
Public Health. 2023 Nov;224:195-202. doi: 10.1016/j.puhe.2023.09.002. Epub 2023 Oct 10.
Insufficient adult vaccination coverage rates remain an international challenge. This nationwide study aimed at exploring vaccination coverage and predictors of influenza, pneumococcal, herpes zoster, tetanus, measles, and hepatitis B vaccine uptake, following the recommendations of the National Immunization Program for adults.
This was a multicenter, mixed-methods study conducted at 23 primary care units in six different regions of Greece.
A pretested questionnaire was administered to three randomly selected adults who visited each practice daily for 30 consecutive working days.
Among the 1571 participants, vaccination coverage for influenza in the high-risk groups was 55%, 36% for pneumococcal disease, 12% for herpes zoster (HZ), 21% for tetanus, 33% for measles, and 11% for hepatitis B. Perception of low susceptibility to disease due to good health status, concerns about side-effects and vaccines' efficacy, and mistrust in pharmaceutical companies were among common factors associated with the vaccines uptake. The strongest factor associated with the participants' vaccination status was their doctor's recommendation (odds ratio [95% confidence interval] influenza: 6.06 [4.52-8.14], pneumococcal disease: 15.73 [10.98-22.52], HZ: 17.01 [9.05-31.96], tetanus: 23.93 [16.20-35.35], measles: 33.47 [16.85-66.47], and hepatitis B: 73.92 [17.47-312.74]). Being well-informed about each vaccine was also a predictor of its uptake.
Vaccination coverage was suboptimal and especially low in tetanus, HZ, and hepatitis B immunization. Person-centered approach, with provision of appropriate information about vaccines' safety and efficacy, responding to each patient's needs, as well as physicians' strong recommendation for vaccination are considered crucial to advocate against the spread of vaccine misinformation and increase vaccination coverage.
成人疫苗接种覆盖率不足仍然是一个国际挑战。本项全国性研究旨在按照国家成人免疫计划的建议，探索流感、肺炎球菌、带状疱疹、破伤风、麻疹和乙型肝炎疫苗接种的覆盖率和预测因素。
这是一项在希腊六个不同地区的 23 个基层医疗单位进行的多中心混合方法研究。
在连续 30 个工作日内，每天向每个诊所随机选择的 3 名成年人发放一份经过预测试的问卷。
在 1571 名参与者中，高危人群的流感疫苗接种率为 55%，肺炎球菌疾病为 36%，带状疱疹为 12%，破伤风为 21%，麻疹为 33%，乙型肝炎为 11%。由于健康状况良好而认为疾病的易感性低、对副作用和疫苗效果的担忧以及对制药公司的不信任，是与疫苗接种相关的常见因素。与参与者接种状况最相关的因素是他们的医生的建议（流感的比值比[95%置信区间]为 6.06[4.52-8.14]，肺炎球菌病为 15.73[10.98-22.52]，带状疱疹为 17.01[9.05-31.96]，破伤风为 23.93[16.20-35.35]，麻疹为 33.47[16.85-66.47]，乙型肝炎为 73.92[17.47-312.74]）。对每种疫苗的充分了解也是其接种的预测因素。
疫苗接种覆盖率不理想，尤其是破伤风、带状疱疹和乙型肝炎疫苗接种率较低。以患者为中心的方法，提供关于疫苗安全性和效果的适当信息，满足每个患者的需求，以及医生强烈建议接种疫苗，被认为是抵制疫苗错误信息传播和提高疫苗接种覆盖率的关键。
