Abstract
Objectives
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.
Methods
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.
Results
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.
Conclusions
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.
Keywords
References
- Immunization summery [Internet]. UNICEF & WHO, 2012 ([cited 2016 August 12]. Available from:)
- Addressing the vaccine confidence gap.Lancet. 2011; 378: 526-535
- Pediatric provider vaccine hesitancy: an under-recognized obstacle to immunizing children.Vaccine. 2015; 33: 6629-6634
- Vaccine hesitancy among general practitioners and its determinants during controversies: a national cross-sectional survey in France.EBioMed. 2015; 2: 889-895
- Le Calendrier des vaccinations et les recommandations vaccinales 2015 selon l’avis du Haut Conseil de la santé publique [Internet]. Bulletin Epidémiologie Hebdomadaire, 2015 ([cited 2016 August 12]. Available from:)
- Couverture Vaccinale [Internet]. Institut de Veille Sanitaire, 2016 ([cited 2016 August 12]. Available from:)
- Baromètre santé médecins généralistes 2009 [Internet].Institut National de Prévention et d'Education pour la Santé, 2011 ([cited 2016 August 12]. Available from:)
- Tracking parental attitudes on vaccination across European countries: the Vaccine Safety, Attitudes, Training and Communication Project (VACSATC).Vaccine. 2010; 28: 5731-5737
- Determinants of refusal of A/H1N1 pandemic vaccination in a high risk population: a qualitative approach.PloS One. 2012; 7: e34054
- Faciliter l’accès aux vaccinations en s’appuyant sur les Agences Régionales de Santé [Internet]. Ecole des Hautes Etudes en Santé Publique, 2013 ([cited 2016 August 12]. Available from:)
- How do physicians immunize their own children? Differences among pediatricians and nonpediatricians.Pediatrics. 2005; 116: e623-e633
- Vaccine hesitancy among general practitioners: evaluation and comparison of their immunisation practice for themselves, their patients and their children.Eur J Clin Microbiol Infect Dis. 2016; ([in press])
- Design of a national and regional survey among French general practitioners and methodology of the first cross-sectional survey dedicated to vaccination.Med Mal Infect. 2015; 45: 403-410
- Visualizing knowledge and attitude factors related to influenza vaccination of physicians.Vaccine. 2015; 33: 885-891
- Finding groups in data: an introduction to cluster analysis.John Wiley & Sons, Chichester2009
- Vaccinology: past achievements, present roadblocks and future promises.Vaccine. 2003; 21: 593-595
- Systematic review of qualitative studies exploring parental beliefs and attitudes toward childhood vaccination identifies common barriers to vaccination.J Clin Epidemiol. 2005; 58: 1081-1088
- Immune overload: parental attitudes toward combination and single antigen vaccines.Vaccine. 2015; 33: 2546-2550
- Missed opportunities for childhood vaccinations in office practices and the effect on vaccination status.Pediatrics. 1993; 91: 1-7
- Parental hesitation as a factor in delayed childhood immunization.J Pediatr Health Care. 2009; 23: 388-393
- Missed opportunities for adolescent vaccination, 2006-2011.J Adolesc Health. 2013; 53: 492-497
- An exploratory qualitative assessment of factors influencing childhood vaccine providers’ intention to recommend immunization in the Netherlands.BMC Public Health. 2012; 12: 128
- Knowledge, attitudes, beliefs and practices of general practitioners towards measles and MMR vaccination in southeastern France in 2012.Clin Microbiol Infect. 2014; 20: 38-43
- SAGE working group dealing with vaccine hesitancy [Internet]. World Health Organization, 2014 ([cited 2016 August 12]. Available from:)
- A look at the pediatrician as parent: experiences with the introduction of varicella vaccine.Clin Pediatr (Philadelph). 2003; 42: 635-640
- Vaccine schedule [Internet]. European Center for Disease Prevention and Control, 2016 ([cited 2016 August 12]. Available from:)
- Mediator scandal rocks French medical community.Lancet. 2011; 377: 890-892
- Barriers to human papillomavirus vaccination among US adolescents.JAMA Pediatr. 2014; 168: 76-82
Article Info
Publication History
Published online: September 03, 2016
Accepted:
August 14,
2016
Received in revised form:
August 13,
2016
Received:
May 29,
2016
Identification
Copyright
© 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd.
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