Skip to main content
Top
Published in: BMC Primary Care 1/2013

Open Access 01-12-2013 | Research article

How French physicians manage with a future change in the primary vaccination of infants against diphtheria, tetanus, pertussis and poliomyelitis? A qualitative study with focus groups

Published in: BMC Primary Care | Issue 1/2013

Login to get access

Abstract

Background

As in other European countries, the French vaccination schedule changes according to epidemiological and socio-economic situations. Further changes are planned for 2013, including the withdrawal of one dose for primary vaccination against diphtheria, tetanus, polio, pertussis and Haemophilus influenzae. A partnership between the French Technical Vaccination Committee and the French Institute for Health and Medical Research designed a study to assess primary care physicians’ agreement about this modification.

Methods

Qualitative study with focus groups and semi-structured interviews in France. Four focus groups were conducted with physicians, supplemented by four individual interviews.

Results

The physicians of the survey had accepted the suggested vaccination schedule well. A few concerns had been underlined: fear of less follow-up care for infants resulting from the removal of one visit driven by the primary vaccination; fear of loss of vaccine efficacy; suspicion of the existence of financial arguments at the origin of this change; and adjustment to current vaccination schedule. Several suggestions were made: providing strong support from health authorities; developing stable and simple recommendations; providing effective tools for monitoring patient’s vaccination status.

Conclusions

Physicians’ opinions suggested a good acceptance of a possible change about primary vaccination against diphtheria, tetanus, polio, pertussis and Haemophilus influenzae. Physicians’ suggestions resulted from this qualitative study on a new vaccination schedule. It showed how that their involvement was feasible for preparing the implementation of a new vaccination schedule.
Literature
1.
go back to reference Haut Conseil de la Santé Publique: Le calendrier des vaccinations et les recommandations vaccinales 2011. BEH. 2011, 10–11: 101-156. Haut Conseil de la Santé Publique: Le calendrier des vaccinations et les recommandations vaccinales 2011. BEH. 2011, 10–11: 101-156.
2.
go back to reference Lopalco PL, de Carvalho HG, Kreidl P, Leitmeyer K, Giesecke J: Childhood vaccination schedules in Europe vary widely. Is this a problem?. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2009, 52 (11): 1095-1098. 10.1007/s00103-009-0960-z.CrossRefPubMed Lopalco PL, de Carvalho HG, Kreidl P, Leitmeyer K, Giesecke J: Childhood vaccination schedules in Europe vary widely. Is this a problem?. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2009, 52 (11): 1095-1098. 10.1007/s00103-009-0960-z.CrossRefPubMed
3.
go back to reference Esposito S, Principi N: Differences in vaccinations in European Union. Hum Vaccin. 2008, 4 (4): 313-315. 10.4161/hv.4.4.5587.CrossRefPubMed Esposito S, Principi N: Differences in vaccinations in European Union. Hum Vaccin. 2008, 4 (4): 313-315. 10.4161/hv.4.4.5587.CrossRefPubMed
4.
go back to reference Taranger J, Trollfors B, Knutsson N, Sundh V, Lagergard T, Ostergaard E: Vaccination of infants with a four-dose and a three-dose vaccination schedule. Vaccine. 1999, 18 (9–10): 884-891.CrossRefPubMed Taranger J, Trollfors B, Knutsson N, Sundh V, Lagergard T, Ostergaard E: Vaccination of infants with a four-dose and a three-dose vaccination schedule. Vaccine. 1999, 18 (9–10): 884-891.CrossRefPubMed
5.
go back to reference Kilpi TM, Silfverdal SA, Nilsson L, Syrjanen R, Belloni C, Desole M, Triban C, Storsaeter J, Soila M, Jacquet JM: Immunogenicity and reactogenicity of two diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated polio virus-Haemophilus influenzae type b vaccines administered at 3, 5 and 11–12 months of age. Hum Vaccin. 2009, 5 (1): 18-25. 10.4161/hv.5.1.6369.CrossRefPubMed Kilpi TM, Silfverdal SA, Nilsson L, Syrjanen R, Belloni C, Desole M, Triban C, Storsaeter J, Soila M, Jacquet JM: Immunogenicity and reactogenicity of two diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated polio virus-Haemophilus influenzae type b vaccines administered at 3, 5 and 11–12 months of age. Hum Vaccin. 2009, 5 (1): 18-25. 10.4161/hv.5.1.6369.CrossRefPubMed
8.
go back to reference Henrich N, Holmes B: Communicating during a pandemic: information the public wants about the disease and new vaccines and drugs. Health Promot Pract. 2011, 12 (4): 610-619. 10.1177/1524839910363536.CrossRefPubMed Henrich N, Holmes B: Communicating during a pandemic: information the public wants about the disease and new vaccines and drugs. Health Promot Pract. 2011, 12 (4): 610-619. 10.1177/1524839910363536.CrossRefPubMed
9.
go back to reference Partouche H, Benainous O, Barthe J, Pierret J, Rigal L, Michaloux M, Gilberg S: A survey about determinants of 2009 pandemic influenza A(H1N1) vaccination among French general practionners patients. Motivac study. Rev Prat. 2011, 61 (10): 1411-1417.PubMed Partouche H, Benainous O, Barthe J, Pierret J, Rigal L, Michaloux M, Gilberg S: A survey about determinants of 2009 pandemic influenza A(H1N1) vaccination among French general practionners patients. Motivac study. Rev Prat. 2011, 61 (10): 1411-1417.PubMed
10.
go back to reference Schwarzinger M, Verger P, Guerville MA, Aubry C, Rolland S, Obadia Y, Moatti JP: Positive attitudes of French general practitioners towards A/H1N1 influenza-pandemic vaccination: a missed opportunity to increase vaccination uptakes in the general public?. Vaccine. 2010, 28 (15): 2743-2748. 10.1016/j.vaccine.2010.01.027.CrossRefPubMed Schwarzinger M, Verger P, Guerville MA, Aubry C, Rolland S, Obadia Y, Moatti JP: Positive attitudes of French general practitioners towards A/H1N1 influenza-pandemic vaccination: a missed opportunity to increase vaccination uptakes in the general public?. Vaccine. 2010, 28 (15): 2743-2748. 10.1016/j.vaccine.2010.01.027.CrossRefPubMed
12.
go back to reference Bonmarin I, Parent du Châtelet I, Lévy-Bruhl D: La rougeole en France: impact épidémiologique d’une couverture vaccinale sub-optimale. BEH. 2004, 16: 61-62. Bonmarin I, Parent du Châtelet I, Lévy-Bruhl D: La rougeole en France: impact épidémiologique d’une couverture vaccinale sub-optimale. BEH. 2004, 16: 61-62.
14.
go back to reference Rabiee F: Focus-group interview and data analysis. Proc Nutr Soc. 2004, 63 (4): 655-660. 10.1079/PNS2004399.CrossRefPubMed Rabiee F: Focus-group interview and data analysis. Proc Nutr Soc. 2004, 63 (4): 655-660. 10.1079/PNS2004399.CrossRefPubMed
15.
16.
go back to reference Krueger RA: Focus Group: A Practical Guide for Applied Research. 2000, Thousand Oaks: SageCrossRef Krueger RA: Focus Group: A Practical Guide for Applied Research. 2000, Thousand Oaks: SageCrossRef
17.
go back to reference Prislin R, Nader PR, De Guire M, Hoy PL, Pung MA, Ross S, Goerlitz MJ, Sawyer MH: Physicians’ immunization knowledge, attitudes, and practices: a valid and internally consistent measurement tool. Am J Prev Med. 1999, 17 (2): 151-152. 10.1016/S0749-3797(99)00054-9.CrossRefPubMed Prislin R, Nader PR, De Guire M, Hoy PL, Pung MA, Ross S, Goerlitz MJ, Sawyer MH: Physicians’ immunization knowledge, attitudes, and practices: a valid and internally consistent measurement tool. Am J Prev Med. 1999, 17 (2): 151-152. 10.1016/S0749-3797(99)00054-9.CrossRefPubMed
18.
go back to reference Kahn JA, Zimet GD, Bernstein DI, Riedesel JM, Lan D, Huang B, Rosenthal SL: Pediatricians’ intention to administer human papillomavirus vaccine: the role of practice characteristics, knowledge, and attitudes. J Adolesc Health. 2005, 37 (6): 502-510. 10.1016/j.jadohealth.2005.07.014.CrossRefPubMed Kahn JA, Zimet GD, Bernstein DI, Riedesel JM, Lan D, Huang B, Rosenthal SL: Pediatricians’ intention to administer human papillomavirus vaccine: the role of practice characteristics, knowledge, and attitudes. J Adolesc Health. 2005, 37 (6): 502-510. 10.1016/j.jadohealth.2005.07.014.CrossRefPubMed
19.
go back to reference Mollema L, Staal JM, van Steenbergen JE, Paulussen TG, de Melker HE: An exploratory qualitative assessment of factors influencing childhood vaccine providers’ intention to recommend immunization in the Netherlands. BMC Publ Health. 2012, 12: 128-10.1186/1471-2458-12-128.CrossRef Mollema L, Staal JM, van Steenbergen JE, Paulussen TG, de Melker HE: An exploratory qualitative assessment of factors influencing childhood vaccine providers’ intention to recommend immunization in the Netherlands. BMC Publ Health. 2012, 12: 128-10.1186/1471-2458-12-128.CrossRef
21.
go back to reference Flahault A, Blanchon T, Dorleans Y, Toubiana L, Vibert JF, Valleron AJ: Virtual surveillance of communicable diseases: a 20-year experience in France. Stat Methods Med Res. 2006, 15 (5): 413-421.PubMed Flahault A, Blanchon T, Dorleans Y, Toubiana L, Vibert JF, Valleron AJ: Virtual surveillance of communicable diseases: a 20-year experience in France. Stat Methods Med Res. 2006, 15 (5): 413-421.PubMed
22.
go back to reference Jefferson T, Demicheli V, Pratt M: Evidence-based vaccinology: the work of the Cochrane Vaccines Field. J Epidemiol Community Health. 1998, 52 (3): 207-208. 10.1136/jech.52.3.207.CrossRefPubMedPubMedCentral Jefferson T, Demicheli V, Pratt M: Evidence-based vaccinology: the work of the Cochrane Vaccines Field. J Epidemiol Community Health. 1998, 52 (3): 207-208. 10.1136/jech.52.3.207.CrossRefPubMedPubMedCentral
23.
go back to reference Pathman DE, Konrad TR, Freed GL, Freeman VA, Koch GG: The awareness-to-adherence model of the steps to clinical guideline compliance. The case of pediatric vaccine recommendations. Med Care. 1996, 34 (9): 873-889. 10.1097/00005650-199609000-00002.CrossRefPubMed Pathman DE, Konrad TR, Freed GL, Freeman VA, Koch GG: The awareness-to-adherence model of the steps to clinical guideline compliance. The case of pediatric vaccine recommendations. Med Care. 1996, 34 (9): 873-889. 10.1097/00005650-199609000-00002.CrossRefPubMed
24.
go back to reference Mickan S, Burls A, Glasziou P: Patterns of ’leakage’ in the utilisation of clinical guidelines: a systematic review. Postgrad Med J. 2011, 87 (1032): 670-679. 10.1136/pgmj.2010.116012.CrossRefPubMedPubMedCentral Mickan S, Burls A, Glasziou P: Patterns of ’leakage’ in the utilisation of clinical guidelines: a systematic review. Postgrad Med J. 2011, 87 (1032): 670-679. 10.1136/pgmj.2010.116012.CrossRefPubMedPubMedCentral
25.
go back to reference Gordon M, Roberts H, Odeka E: Knowledge and attitudes of parents and professionals to neonatal BCG vaccination in light of recent UK policy changes: a questionnaire study. BMC Infect Dis. 2007, 7: 82-10.1186/1471-2334-7-82.CrossRefPubMedPubMedCentral Gordon M, Roberts H, Odeka E: Knowledge and attitudes of parents and professionals to neonatal BCG vaccination in light of recent UK policy changes: a questionnaire study. BMC Infect Dis. 2007, 7: 82-10.1186/1471-2334-7-82.CrossRefPubMedPubMedCentral
26.
go back to reference Rossignol L, Guthmann JP, Kerneis S, Aubin-Auger I, Lasserre A, Chauvin P, Pelat C, Hanslik T, Levy-Bruhl D, Blanchon T: Barriers to implementation of the new targeted BCG vaccination in France: a cross sectional study. Vaccine. 2011, 29 (32): 5232-5237. 10.1016/j.vaccine.2011.05.020.CrossRefPubMed Rossignol L, Guthmann JP, Kerneis S, Aubin-Auger I, Lasserre A, Chauvin P, Pelat C, Hanslik T, Levy-Bruhl D, Blanchon T: Barriers to implementation of the new targeted BCG vaccination in France: a cross sectional study. Vaccine. 2011, 29 (32): 5232-5237. 10.1016/j.vaccine.2011.05.020.CrossRefPubMed
27.
go back to reference Fiks AG, Grundmeier RW, Biggs LM, Localio AR, Alessandrini EA: Impact of clinical alerts within an electronic health record on routine childhood immunization in an urban pediatric population. Pediatrics. 2007, 120 (4): 707-714. 10.1542/peds.2007-0257.CrossRefPubMed Fiks AG, Grundmeier RW, Biggs LM, Localio AR, Alessandrini EA: Impact of clinical alerts within an electronic health record on routine childhood immunization in an urban pediatric population. Pediatrics. 2007, 120 (4): 707-714. 10.1542/peds.2007-0257.CrossRefPubMed
28.
go back to reference Klatt TE, Hopp E: Effect of a best-practice alert on the rate of influenza vaccination of pregnant women. Obstet Gynecol. 2012, 119 (2 Pt 1): 301-305.CrossRefPubMed Klatt TE, Hopp E: Effect of a best-practice alert on the rate of influenza vaccination of pregnant women. Obstet Gynecol. 2012, 119 (2 Pt 1): 301-305.CrossRefPubMed
29.
go back to reference Ledwich LJ, Harrington TM, Ayoub WT, Sartorius JA, Newman ED: Improved influenza and pneumococcal vaccination in rheumatology patients taking immunosuppressants using an electronic health record best practice alert. Arthritis Rheum. 2009, 61 (11): 1505-1510. 10.1002/art.24873.CrossRefPubMed Ledwich LJ, Harrington TM, Ayoub WT, Sartorius JA, Newman ED: Improved influenza and pneumococcal vaccination in rheumatology patients taking immunosuppressants using an electronic health record best practice alert. Arthritis Rheum. 2009, 61 (11): 1505-1510. 10.1002/art.24873.CrossRefPubMed
30.
go back to reference Taylor JA, Darden PM, Brooks DA, Hendricks JW, Baker AE, Wasserman RC: Practitioner policies and beliefs and practice immunization rates: a study from Pediatric Research in Office Settings and the National Medical Association. Pediatrics. 2002, 109 (2): 294-300. 10.1542/peds.109.2.294.CrossRefPubMed Taylor JA, Darden PM, Brooks DA, Hendricks JW, Baker AE, Wasserman RC: Practitioner policies and beliefs and practice immunization rates: a study from Pediatric Research in Office Settings and the National Medical Association. Pediatrics. 2002, 109 (2): 294-300. 10.1542/peds.109.2.294.CrossRefPubMed
Metadata
Title
How French physicians manage with a future change in the primary vaccination of infants against diphtheria, tetanus, pertussis and poliomyelitis? A qualitative study with focus groups
Publication date
01-12-2013
Published in
BMC Primary Care / Issue 1/2013
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-14-85

Other articles of this Issue 1/2013

BMC Primary Care 1/2013 Go to the issue