Low acceptability of A/H1N1 pandemic vaccination in French adult population: did public health policy fuel public dissonance?
Low acceptability of A/H1N1 pandemic vaccination in French adult population: did public health policy fuel public dissonance?
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DOI：
10.1371/journal.pone.0010199
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发表时间：
2010-04-16
期刊：
影响因子：
3.7
通讯作者：
Moatti JP
中科院分区：
文献类型：
--
作者：
Schwarzinger M;Flicoteaux R;Cortarenoda S;Obadia Y;Moatti JP
2009年7月，法国公共卫生当局开始了针对2009年A/H1N1大流行性流感的大规模疫苗接种运动。我们调查了普通人群对大流行疫苗接种的态度和行为。我们于2009年11月17日至25日对2,253名18岁至的法国代表性成年人进行了横断面在线调查(完成率：93.8%)。主要结果是甲型H1N1流感疫苗接种的可接受性，根据以前收到疫苗或打算接种疫苗的定义(“是，当然”，“是，可能”)。总体上，17.0%的受访者接受了甲型H1N1疫苗接种(CI为95%，15.5%至18.7%)。与可接受性相关的独立因素包括：男性(p = .0001)；年龄较大(p = .002)；受教育程度最高或最低(p = .016)；非文职职业(p = .011)；只有一个孩子(p = .008)；以及在过去3年内接受季节性流感疫苗接种(p<；.0001)。孕妇(37.9%)和其他慢性病高危人群(34.8%)的可接受性也显著较高(p = .002)。只有35.5%的受访者认为甲型H1N1流感是一种严重疾病，12.7%的受访者认为与甲型H1N1流感密切相关的病例具有较高的可接受性(p<；.0001和p = .006)。与26.0%没有咨询初级保健医生的受访者相比，正式建议接种疫苗的8.0%受访者的可接受性显著高于未被建议接种疫苗的63.7%受访者(分别为15.8%、59.5%和11.7%-p<；0.0001)。在拒绝接种疫苗的受访者中，71.2%的人表示担心疫苗安全。我们的调查发生在法国疫情高峰期的前一周。我们发现，旨在提高人们对风险严重性的感知的令人担忧的公共卫生信息被日常个人经验所抵消，这些个人经验并不证实威胁，而疫苗安全是一个主要问题。这种不和谐可能因为没有让初级保健医生参与大规模疫苗接种活动而被放大。
In July 2009, French public health authorities embarked in a mass vaccination campaign against A/H1N1 2009 pandemic-influenza. We explored the attitudes and behaviors of the general population toward pandemic vaccination. We conducted a cross-sectional online survey among 2,253 French representative adults aged 18 to 64 from November 17 to 25, 2009 (completion rate: 93.8%). The main outcome was the acceptability of A/H1N1 vaccination as defined by previous receipt or intention to get vaccinated (“Yes, certainly”, “Yes, probably”). Overall 17.0% (CI 95%, 15.5% to 18.7%) of respondents accepted A/H1N1 vaccination. Independent factors associated with acceptability included: male sex (p = .0001); older age (p = .002); highest or lowest level of education (p = .016); non-clerical occupation (p = .011); having only one child (p = .008); and having received seasonal flu vaccination in prior 3 years (p<.0001). Acceptability was also significantly higher among pregnant women (37.9%) and other at risk groups with chronic diseases (34.8%) (p = .002). Only 35.5% of respondents perceived A/H1N1 influenza illness as a severe disease and 12.7% had experienced A/H1N1 cases in their close relationships with higher acceptability (p<.0001 and p = .006, respectively). In comparison to 26.0% respondents who did not consult their primary care physician, acceptability was significantly higher among 8.0% respondents who were formally advised to get vaccinated, and lower among 63.7% respondents who were not advised to get vaccinated (respectively: 15.8%, 59.5% and 11.7%- p<.0001). Among respondents who refused vaccination, 71.2% expressed concerns about vaccine safety. Our survey occurred one week before the peak of the pandemic in France. We found that alarming public health messages aiming at increasing the perception of risk severity were counteracted by daily personal experience which did not confirm the threat, while vaccine safety was a major issue. This dissonance may have been amplified by having not involved primary care physicians in the mass vaccination campaign.
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