Vaccine hesitancy among general practitioners: evaluation and comparison of their immunisation practice for themselves, their patients and their children

Abstract

To gain knowledge about vaccine hesitancy among general practitioners (GPs), we conducted a survey to compare their vaccination attitudes for themselves, their children and their patients. A questionnaire survey was sent to GPs working in private practice in the Rhône-Alpes region, France, between October 2013 and January 2014. GPs' immunisation practices for diphtheria-tetanus-poliomyelitis (DTP), measles-mumps-rubella (MMR), pneumococcal, pertussis, hepatitis B (hepB), human papillomavirus (HPV), seasonal and H1N1 influenza and meningococcal C (menC) vaccines were considered. Divergence was defined by the presence of at least one different immunisation practice between their patients and their children. A total of 693 GPs answered the questionnaire. When considering all investigated vaccines, 45.7 % of divergence was found. Individually, divergence was highest for the newest and more controversial, i.e. HPV (11.8 %), hepB (13.1 %), menC (23.7 %) and pneumococcal (19.8 %) vaccines. Only 73.9 % of GPs declared that they recommended HPV vaccine for their daughters. After multivariate analysis, older age was associated with higher risk of divergence. According to the French 2012 recommendations, GPs were insufficiently immunised, with 88 % for DTP and 72 % for pertussis. GPs declared to recommend vaccination against DTP, pertussis and MMR for their patients and their children in more than 95 % of cases. The declared rates of recommendation were lower than 90 % for other vaccines. These results bring new insight about vaccine hesitancy. GPs have divergent immunisation attitudes toward their relatives and their patients, especially when considering the newest and most controversial vaccines, with HPV vaccine being the main focus of controversies.

Discrepancies between general practitioners' vaccination recommendations for their patients and practices for their children

“…We hypothesize that most GPs are convinced of the efficacy and the safety of this vaccine, since 77% reported that their children were vaccinated, but that barriers prevent some from recommending this vaccine to their patients. Killian et al found in their survey the same finding, since HepB vaccine coverage rate reported by GPs was higher for their children (100%), than for their patients (87%, p <0.001) [12]. Numerous patient-related barriers exist.…”

“…To the best of our knowledge, only two studies have examined this topic; the first one, a cross-sectional questionnaire survey conducted by Posfay et al in Switzerland in 2004 found that 93% of the 1017 surveyed physicians (paediatricians and other doctors) agreed with official vaccination recommendations and would apply them to their own children [11]; however, this work did not compare GPs' vaccination behaviour for their patients and their own children. The second one is a very recently published survey conducted in 2013 in one French region, with a low response rate (12.5%), that compared vaccination behaviours of GPs for themselves, their children and their patients [12]. They found that vaccination coverage rates reported by GPs were higher for their children than for their patients for HepB (100% versus 87%), and higher for their patients than for their children for pneumococcal vaccine (90% versus 84%) and HPV vaccine (83% versus 74%).…”

Healthcare Workers’ Knowledge, Attitudes, and Practices about Vaccinations: A Cross-Sectional Study in Italy

“…Indeed, since it is well established that HCWs play a role in nosocomial transmission of infectious diseases, the low-level coverage of those susceptible did not contribute to limit the spread of infections and might not provide indirect protection for the patients. The findings of previous investigations showed a higher coverage for several vaccinations in different groups of HCWs compared to the results of this survey, with values of 41.7% [21] and 45.7% [22] for influenza in Slovenia and France, respectively; values of 93.7% and 80.5% were reported for diphtheria-tetanus-acellular-pertussis and measles-mumps-rubella in Italy, respectively [12]; values of 88% and 72% were reported for diphtheria-tetanus-poliomyelitis and pertussis in France, respectively [23]; and a value of 50.5% was reported for pertussis in Australia [24]. One possible explanation for the observed poor immunization coverage could be the lack of free on-site vaccines at work.…”

Investigating Italian parents' vaccine hesitancy: A cross-sectional survey

“…Several studies regarding the hesitancy in both parents [18][19][20][21] and in health care workers [22][23][24] have been published, but to the best that we could ascertain no previous research are currently available in Italy regarding childhood vaccine hesitancy among parents. Thus, to address this knowledge gap, the present crosssectional survey was designed to assess the prevalence of vaccine hesitancy and to identify factors associated with vaccine hesitancy among a sample of parents of children aged 2 to 6 years in Italy and the results could be used to target optimal public health strategies to improve overall vaccination coverage.…”