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Environmental Health and Preventive Medicine

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01-09-2011 | Regular Article

Physicians’ recommendations to their patients concerning a novel pandemic vaccine: a cross-sectional survey of the 2009 influenza A/H1N1 pandemic in Japan

Authors: Yusuke Inoue, Kenji Matsui

Published in: Environmental Health and Preventive Medicine | Issue 5/2011

Abstract

Objectives

Striking a balance between the rapid availability of a novel vaccine while ensuring its safety, quality, and efficacy is a major challenge during a pandemic. We aimed to elucidate physicians’ attitudes regarding the novel vaccine during the influenza A/H1N1 pandemic of 2009, and to determine factors that affected their vaccination recommendations to patients.

Methods

Of a random sample of 1,000 general practitioners (GPs) in Japan, 515 participated in the cross-sectional anonymous survey conducted just before the novel vaccine was available (between 28 September and 18 October 2009).

Results

A total of 453 GPs (88.3%) replied that they intended to receive the new vaccine themselves; however, only 177 GPs (34.6%) intended to proactively recommend it to their patients. The anticipated cost of the vaccine negatively influenced the intention to vaccinate themselves and their recommendations to patients (P < 0.001, χ ² test). Results of multivariate logistic regression analysis showed that physicians with experience in influenza A/H1N1 patient contacts [1–20 contacts, odds ratio (OR) = 7.49 (95% confidence interval [CI]: 1.73–32.36), P = 0.007; >20 contacts, OR = 8.03 (95% CI: 1.77–36.50), P = 0.007, compared with no contacts] were more likely to recommend the vaccine to patients, whereas those with knowledge of the fear on the causal association between Guillain–Barré syndrome (GBS) cases and the 1976 swine flu vaccination in the USA were less likely to recommend the vaccine [OR = 0.66 (95% CI: 0.45–0.97), P = 0.036].

Conclusions

Results of our survey indicate that physicians experience a moral conflict regarding recommending the novel vaccine to patients, which may be the result of their own experience with the disease, knowledge of vaccine side-effects, and cost.

Charatan F. UN warns that swine flu outbreak could turn into pandemic. BMJ. 2009;338:b1751.PubMedCrossRef

European Centre for Disease Prevention and Control. ECDC situation update on (A H1N1) influenza pandemic. 2009. http://www.ecdc.europa.eu/en/aboutus/organisation/Director%20Speeches/0912_DS_ZJ_Situation_Update_on_Influenza_Pandemic.pdf. Accessed 30 Sept 2010.

Doshi P. Calibrated response to emerging infections. BMJ. 2009;339:b3471.PubMedCrossRef

Cohen E. When a pandemic isn’t a pandemic. CNN. 2009. http://edition.cnn.com/2009/HEALTH/05/04/swine.flu.pandemic/index.html. Accessed 30 Sept 2010.

Wood JM. Developing vaccines against pandemic influenza. Philos Trans R Soc Lond B Biol Sci. 2001;356:1953–60.PubMedCrossRef

Marks JS, Halpin TJ. Guillain–Barré syndrome in recipients of A/New Jersey influenza vaccine. JAMA. 1980;243:2490–4.PubMedCrossRef

World Health Organization. Safety of pandemic (H1N1) 2009 vaccines. 2009. http://www.who.int/csr/disease/swineflu/frequently_asked_questions/vaccine_preparedness/safety_approval/en/index.html. Accessed 30 Sept 2010.

Neustadt RE, Fineberg HV. The swine flu affair. Honolulu: University Press of the Pacific; 2005.

Daley MF, Crane LA, Chandramouli V, Beaty BL, Barrow J, Allred N, et al. Influenza among healthy young children: changes in parental attitudes and predictors for immunization during the 2003 to 2004 influenza season. Pediatrics. 2006;117:e268–77.PubMedCrossRef

10.

Nowalk MP, Lin CJ, Zimmerman RK, Ko FS, Hoberman A, Zoffel L, et al. Changes in parents’ perceptions of infant influenza vaccination over two years. J Natl Med Assoc. 2007;99:636–41.PubMed

11.

Sheather J. Ethics in the face of uncertainty: preparing for pandemic flu. Clin Ethics. 2006;1:224–7.CrossRef

12.

British Medical Association Ethics Department. Public health dimensions of medical practice. In: British Medical Association, editor. Medical ethics today. 2nd ed. London: BMJ Publishing Group; 2004. p. 703–34.

13.

Chor JS, Ngai KL, Goggins WB, Wong MC, Wong SY, Lee N, et al. Willingness of Hong Kong healthcare workers to accept pre-pandemic influenza vaccination at different WHO alert levels: two questionnaire surveys. BMJ. 2009;339:b3391.PubMedCrossRef

14.

Lautenbach E, Saint S, Henderson DK, Harris AD. Initial response of health care institutions to emergence of H1N1 influenza: experiences, obstacles, and perceived future needs. Clin Infect Dis. 2010;50:523–7.PubMedCrossRef

15.

Rachiotis G, Mouchtouri VA, Kremastinou J, Gourgoulianis K, Hadjichristodoulou C. Low acceptance of vaccination against the 2009 pandemic influenza A(H1N1) among healthcare workers in Greece. Euro Surveill. 2010;15:pii19486. http://edition.cnn.com/2009/HEALTH/05/04/swine.flu.pandemic/index.html. Accessed 30 Sept 2010.

16.

World Health Organization. Pandemic influenza vaccine manufacturing process and timeline. Pandemic (H1N1) 2009 briefing note 7. 2009. http://www.who.int/csr/disease/swineflu/notes/h1n1_vaccine_20090806/en/index.html. Accessed 30 Sept 2010.

17.

Chan M. World now at the start of 2009 influenza pandemic. Statement to the press by World Health Organization Director-General. 2009. http://www.who.int/mediacentre/news/statements/2009/h1n1_pandemic_phase6_20090611/en/index.html. Accessed 30 Sept 2010.

18.

Ministry of Health, Labour and Welfare of Japan. Informal meeting on the novel influenza vaccine. 2009 (in Japanese). http://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou04/pdf/090907_01.pdf. Accessed 30 Sept 2010.

19.

Ministry of Health, Labour and Welfare of Japan. The first shipping of the A/H1N1 influenza vaccine (in Japanese). 2009. http://www.mhlw.go.jp/kinkyu/kenkou/influenza/houdou/2009/10/dl/infuh1006-04.pdf. Accessed 30 Sept 2010.

20.

World Health Organization. Safety of pandemic vaccines, Pandemic (H1N1) 2009 briefing note 6. 2009. http://www.who.int/csr/disease/swineflu/notes/h1n1_safety_vaccines_20090805/en/index.html. Accessed 30 Sept 2010.

21.

Ministry of Health, Labour and Welfare of Japan. The interim report on the clinical trial of the novel A/H1N1 vaccine (in Japanese). 2009. http://www.mhlw.go.jp/kinkyu/kenkou/influenza/dl/infu091016-01.pdf. Accessed 30 Sept 2010.

22.

World Health Organization. WHO recommendations on pandemic (H1N1) 2009 vaccines, Pandemic (H1N1) 2009 briefing note 2. 2009. http://www.who.int/csr/disease/swineflu/notes/h1n1_vaccine_20090713/en/index.html. Accessed 30 Sept 2010.

23.

World Health Organization. Preparing for the second wave: lessons from current outbreaks. Pandemic (H1N1) 2009 briefing note 9. 2009. http://www.who.int/csr/disease/swineflu/notes/h1n1_second_wave_20090828/en/index.html. Accessed 30 Sept 2010.

24.

World Health Organization. Experts advise WHO on pandemic vaccine policies and strategies. Pandemic (H1N1) 2009 briefing note 14. 2009. http://www.who.int/csr/disease/swineflu/notes/briefing_20091030/en/index.html. Accessed 30 Sept 2010.

25.

Evans G. Vaccine injury compensation programs worldwide. Vaccine. 1999;17(suppl 3):S25–35.PubMedCrossRef

26.

Centers for Disease Control and Prevention. Questions and answers on 2009 H1N1 vaccine financing. 2009. http://www.cdc.gov/H1N1flu/vaccination/statelocal/vaccine_financing.htm. Accessed 30 Sept 2010.

27.

National Health Service. Information on the swine flu vaccine. 2009. http://www.nhs.uk/conditions/pandemic-flu/pages/vaccine.aspx.

28.

Xinhua News Agency. Beijing starts free A/H1N1 flu vaccination. 2009. http://news.xinhuanet.com/english/2009-10/21/content_12290207.htm. Accessed 30 Sept 2010.

29.

Ministry of Health, Labour and Welfare of Japan. Novel influenza vaccination: what you have to know and understand (administration briefers) (in Japanese). 2009. http://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou04/pdf/p091022-1.pdf. Accessed 30 Sept 2010.

30.

Ministry of Health, Labour and Welfare of Japan. The task force on vaccine demand: The demand of vaccine in 2007 (in Japanese). 2008. http://www.mhlw.go.jp/shingi/2008/06/dl/s0618-9d.pdf. Accessed 30 Sept 2010.

31.

Nexøe J, Kragstrup J, Rønne T. Impact of postal invitations and user fee on influenza vaccination rates among the elderly. A randomized controlled trial in general practice. Scand J Prim Health Care. 1997;15:109–12.PubMedCrossRef

32.

Seale H, McLaws ML, Heywood AE, Ward KF, Lowbridge CP, Van D, et al. The community’s attitude towards swine flu and pandemic influenza. Med J Aust. 2009;191:267–9.PubMed

33.

Statistics and Information Department, Minister’s Secretariat, Ministry of Health, Labour and Welfare of Japan. The biyearly report on the general situation of medical practitioners, dentists, and pharmacists. (in Japanese). 2006. http://www.mhlw.go.jp/toukei/saikin/hw/ishi/06/index.html. Accessed 30 Sept 2010.

Title: Physicians’ recommendations to their patients concerning a novel pandemic vaccine: a cross-sectional survey of the 2009 influenza A/H1N1 pandemic in Japan
Authors: Yusuke Inoue
Kenji Matsui
Publication date: 01-09-2011
Publisher: Springer Japan
Published in: Environmental Health and Preventive Medicine / Issue 5/2011
Print ISSN: 1342-078X
Electronic ISSN: 1347-4715
DOI: https://doi.org/10.1007/s12199-010-0202-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Physicians’ recommendations to their patients concerning a novel pandemic vaccine: a cross-sectional survey of the 2009 influenza A/H1N1 pandemic in Japan

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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