Dutch healthcare professionals' opinion on vaccination and education to prevent infections in immunocompromised patients: A mixed-method study with recommendations for daily practice.
Identifieur interne : 000015 ( Main/Curation ); précédent : 000014; suivant : 000016Dutch healthcare professionals' opinion on vaccination and education to prevent infections in immunocompromised patients: A mixed-method study with recommendations for daily practice.
Auteurs : L. Doornekamp [Pays-Bas] ; W. De Jong [Pays-Bas] ; M N Wagener [Pays-Bas] ; M. Goeijenbier [Pays-Bas] ; E C M. Van Gorp [Pays-Bas]Source :
- Vaccine [ 1873-2518 ] ; 2019.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Centres de soins tertiaires (MeSH), Connaissances, attitudes et pratiques en santé (MeSH), Enquêtes et questionnaires (MeSH), Femelle (MeSH), Grippe humaine (prévention et contrôle), Guides de bonnes pratiques cliniques comme sujet (MeSH), Humains (MeSH), Mâle (MeSH), Pays-Bas (MeSH), Personnel de santé (psychologie), Personnel de santé (statistiques et données numériques), Plan de recherche (MeSH), Recherche qualitative (MeSH), Sujet immunodéprimé (MeSH), Vaccination (méthodes), Vaccination (psychologie), Vaccins antigrippaux (administration et posologie), Éducation du patient comme sujet (MeSH).
- MESH :
- administration et posologie : Vaccins antigrippaux.
- méthodes : Vaccination.
- prévention et contrôle : Grippe humaine.
- psychologie : Personnel de santé, Vaccination.
- statistiques et données numériques : Personnel de santé.
- Adulte, Centres de soins tertiaires, Connaissances, attitudes et pratiques en santé, Enquêtes et questionnaires, Femelle, Guides de bonnes pratiques cliniques comme sujet, Humains, Mâle, Pays-Bas, Plan de recherche, Recherche qualitative, Sujet immunodéprimé, Éducation du patient comme sujet.
- Wicri :
- geographic : Pays-Bas.
English descriptors
- KwdEn :
- Adult (MeSH), Female (MeSH), Health Knowledge, Attitudes, Practice (MeSH), Health Personnel (psychology), Health Personnel (statistics & numerical data), Humans (MeSH), Immunocompromised Host (MeSH), Influenza Vaccines (administration & dosage), Influenza, Human (prevention & control), Male (MeSH), Netherlands (MeSH), Patient Education as Topic (MeSH), Practice Guidelines as Topic (MeSH), Qualitative Research (MeSH), Research Design (MeSH), Surveys and Questionnaires (MeSH), Tertiary Care Centers (MeSH), Vaccination (methods), Vaccination (psychology).
- MESH :
- chemical , administration & dosage : Influenza Vaccines.
- geographic : Netherlands.
- methods : Vaccination.
- prevention & control : Influenza, Human.
- psychology : Health Personnel, Vaccination.
- statistics & numerical data : Health Personnel.
- Adult, Female, Health Knowledge, Attitudes, Practice, Humans, Immunocompromised Host, Male, Patient Education as Topic, Practice Guidelines as Topic, Qualitative Research, Research Design, Surveys and Questionnaires, Tertiary Care Centers.
Abstract
BACKGROUND
The fast-growing population of immunocompromised patients (ICP) is more vulnerable to infectious diseases, demanding strategies to protect them. These strategies seem inconsistent in available guidelines and in practices. We aim to evaluate healthcare professionals' (HCP) opinions on vaccination to reduce the number and severity of infections in ICP.
METHODS
A mixed-method study, with an exploratory sequential design, was performed. Medical specialists from various departments in a tertiary care center in the Netherlands were invited for semi-structured interviews to explore their perspective on preventive care of ICP. Topics that play a substantial role in daily practice for ICP were translated into a survey to gain insight into what extent opinions were generalizable to Erasmus Medical Center.
RESULTS
Surveys were completed by 689 HCP (43% of the invitees), 269 of them treated at least two ICP weekly on average and were considered eligible for further analysis. Quantitative data showed that according to 80 percent of HCP, preventive care for ICP can be improved. Education was chosen by 40 percent as the most important intervention to reduce the number and severity of infections. Vaccinations were valued as important by seventeen percent of HCP. Except for influenza, vaccinations were not regularly discussed during routine consultations. Difficulties to administer vaccinations were experienced by 75 percent of HCP.
CONCLUSION
According to our respondents, education is the most promising intervention to reduce the number and severity of infections in ICP. To reach a higher vaccine uptake, we recommend HCP to address vaccinations more frequently during consultations and to search for solutions to alleviate barriers to vaccinate.
DOI: 10.1016/j.vaccine.2019.01.075
PubMed: 30739793
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Goeijenbier</name><affiliation wicri:level="1"><nlm:affiliation>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam</wicri:regionArea></affiliation></author><author><name sortKey="Van Gorp, E C M" sort="Van Gorp, E C M" uniqKey="Van Gorp E" first="E C M" last="Van Gorp">E C M. Van Gorp</name><affiliation wicri:level="1"><nlm:affiliation>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Internal Medicine/Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, the Netherlands. 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Doornekamp</name><affiliation wicri:level="1"><nlm:affiliation>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands. Electronic address: l.doornekamp@erasmusmc.nl.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam</wicri:regionArea></affiliation></author><author><name sortKey="De Jong, W" sort="De Jong, W" uniqKey="De Jong W" first="W" last="De Jong">W. De Jong</name><affiliation wicri:level="1"><nlm:affiliation>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands. Electronic address: w.dejong.2@erasmusmc.nl.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam</wicri:regionArea></affiliation></author><author><name sortKey="Wagener, M N" sort="Wagener, M N" uniqKey="Wagener M" first="M N" last="Wagener">M N Wagener</name><affiliation wicri:level="1"><nlm:affiliation>Center of Expertise Innovations in Care, Rotterdam University of Applied Science, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Center of Expertise Innovations in Care, Rotterdam University of Applied Science</wicri:regionArea></affiliation></author><author><name sortKey="Goeijenbier, M" sort="Goeijenbier, M" uniqKey="Goeijenbier M" first="M" last="Goeijenbier">M. Goeijenbier</name><affiliation wicri:level="1"><nlm:affiliation>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam</wicri:regionArea></affiliation></author><author><name sortKey="Van Gorp, E C M" sort="Van Gorp, E C M" uniqKey="Van Gorp E" first="E C M" last="Van Gorp">E C M. Van Gorp</name><affiliation wicri:level="1"><nlm:affiliation>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Internal Medicine/Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, the Netherlands. Electronic address: e.vangorp@erasmusmc.nl.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Internal Medicine/Infectious Diseases, Erasmus MC, University Medical Center Rotterdam</wicri:regionArea></affiliation></author></analytic><series><title level="j">Vaccine</title><idno type="eISSN">1873-2518</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Female (MeSH)</term><term>Health Knowledge, Attitudes, Practice (MeSH)</term><term>Health Personnel (psychology)</term><term>Health Personnel (statistics & numerical data)</term><term>Humans (MeSH)</term><term>Immunocompromised Host (MeSH)</term><term>Influenza Vaccines (administration & dosage)</term><term>Influenza, Human (prevention & control)</term><term>Male (MeSH)</term><term>Netherlands (MeSH)</term><term>Patient Education as Topic (MeSH)</term><term>Practice Guidelines as Topic (MeSH)</term><term>Qualitative Research (MeSH)</term><term>Research Design (MeSH)</term><term>Surveys and Questionnaires (MeSH)</term><term>Tertiary Care Centers (MeSH)</term><term>Vaccination (methods)</term><term>Vaccination (psychology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Centres de soins tertiaires (MeSH)</term><term>Connaissances, attitudes et pratiques en santé (MeSH)</term><term>Enquêtes et questionnaires (MeSH)</term><term>Femelle (MeSH)</term><term>Grippe humaine (prévention et contrôle)</term><term>Guides de bonnes pratiques cliniques comme sujet (MeSH)</term><term>Humains (MeSH)</term><term>Mâle (MeSH)</term><term>Pays-Bas (MeSH)</term><term>Personnel de santé (psychologie)</term><term>Personnel de santé (statistiques et données numériques)</term><term>Plan de recherche (MeSH)</term><term>Recherche qualitative (MeSH)</term><term>Sujet immunodéprimé (MeSH)</term><term>Vaccination (méthodes)</term><term>Vaccination (psychologie)</term><term>Vaccins antigrippaux (administration et posologie)</term><term>Éducation du patient comme sujet (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Netherlands</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Vaccins antigrippaux</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Vaccination</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Vaccination</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Personnel de santé</term><term>Vaccination</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Health Personnel</term><term>Vaccination</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Health Personnel</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Personnel de santé</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Female</term><term>Health Knowledge, Attitudes, Practice</term><term>Humans</term><term>Immunocompromised Host</term><term>Male</term><term>Patient Education as Topic</term><term>Practice Guidelines as Topic</term><term>Qualitative Research</term><term>Research Design</term><term>Surveys and Questionnaires</term><term>Tertiary Care Centers</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Centres de soins tertiaires</term><term>Connaissances, attitudes et pratiques en santé</term><term>Enquêtes et questionnaires</term><term>Femelle</term><term>Guides de bonnes pratiques cliniques comme sujet</term><term>Humains</term><term>Mâle</term><term>Pays-Bas</term><term>Plan de recherche</term><term>Recherche qualitative</term><term>Sujet immunodéprimé</term><term>Éducation du patient comme sujet</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Pays-Bas</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The fast-growing population of immunocompromised patients (ICP) is more vulnerable to infectious diseases, demanding strategies to protect them. These strategies seem inconsistent in available guidelines and in practices. We aim to evaluate healthcare professionals' (HCP) opinions on vaccination to reduce the number and severity of infections in ICP.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A mixed-method study, with an exploratory sequential design, was performed. Medical specialists from various departments in a tertiary care center in the Netherlands were invited for semi-structured interviews to explore their perspective on preventive care of ICP. Topics that play a substantial role in daily practice for ICP were translated into a survey to gain insight into what extent opinions were generalizable to Erasmus Medical Center.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Surveys were completed by 689 HCP (43% of the invitees), 269 of them treated at least two ICP weekly on average and were considered eligible for further analysis. Quantitative data showed that according to 80 percent of HCP, preventive care for ICP can be improved. Education was chosen by 40 percent as the most important intervention to reduce the number and severity of infections. Vaccinations were valued as important by seventeen percent of HCP. Except for influenza, vaccinations were not regularly discussed during routine consultations. Difficulties to administer vaccinations were experienced by 75 percent of HCP.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>According to our respondents, education is the most promising intervention to reduce the number and severity of infections in ICP. To reach a higher vaccine uptake, we recommend HCP to address vaccinations more frequently during consultations and to search for solutions to alleviate barriers to vaccinate.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">30739793</PMID><DateCompleted><Year>2020</Year><Month>08</Month><Day>04</Day></DateCompleted><DateRevised><Year>2020</Year><Month>08</Month><Day>04</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1873-2518</ISSN><JournalIssue CitedMedium="Internet"><Volume>37</Volume><Issue>11</Issue><PubDate><Year>2019</Year><Month>03</Month><Day>07</Day></PubDate></JournalIssue><Title>Vaccine</Title><ISOAbbreviation>Vaccine</ISOAbbreviation></Journal><ArticleTitle>Dutch healthcare professionals' opinion on vaccination and education to prevent infections in immunocompromised patients: A mixed-method study with recommendations for daily practice.</ArticleTitle><Pagination><MedlinePgn>1476-1483</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0264-410X(19)30160-4</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.vaccine.2019.01.075</ELocationID><Abstract><AbstractText Label="BACKGROUND">The fast-growing population of immunocompromised patients (ICP) is more vulnerable to infectious diseases, demanding strategies to protect them. These strategies seem inconsistent in available guidelines and in practices. We aim to evaluate healthcare professionals' (HCP) opinions on vaccination to reduce the number and severity of infections in ICP.</AbstractText><AbstractText Label="METHODS">A mixed-method study, with an exploratory sequential design, was performed. Medical specialists from various departments in a tertiary care center in the Netherlands were invited for semi-structured interviews to explore their perspective on preventive care of ICP. Topics that play a substantial role in daily practice for ICP were translated into a survey to gain insight into what extent opinions were generalizable to Erasmus Medical Center.</AbstractText><AbstractText Label="RESULTS">Surveys were completed by 689 HCP (43% of the invitees), 269 of them treated at least two ICP weekly on average and were considered eligible for further analysis. Quantitative data showed that according to 80 percent of HCP, preventive care for ICP can be improved. Education was chosen by 40 percent as the most important intervention to reduce the number and severity of infections. Vaccinations were valued as important by seventeen percent of HCP. Except for influenza, vaccinations were not regularly discussed during routine consultations. Difficulties to administer vaccinations were experienced by 75 percent of HCP.</AbstractText><AbstractText Label="CONCLUSION">According to our respondents, education is the most promising intervention to reduce the number and severity of infections in ICP. To reach a higher vaccine uptake, we recommend HCP to address vaccinations more frequently during consultations and to search for solutions to alleviate barriers to vaccinate.</AbstractText><CopyrightInformation>Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Doornekamp</LastName><ForeName>L</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands. Electronic address: l.doornekamp@erasmusmc.nl.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>de Jong</LastName><ForeName>W</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands. Electronic address: w.dejong.2@erasmusmc.nl.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wagener</LastName><ForeName>M N</ForeName><Initials>MN</Initials><AffiliationInfo><Affiliation>Center of Expertise Innovations in Care, Rotterdam University of Applied Science, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Goeijenbier</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>van Gorp</LastName><ForeName>E C M</ForeName><Initials>ECM</Initials><AffiliationInfo><Affiliation>Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Internal Medicine/Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, the Netherlands. Electronic address: e.vangorp@erasmusmc.nl.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>02</Month><Day>07</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Vaccine</MedlineTA><NlmUniqueID>8406899</NlmUniqueID><ISSNLinking>0264-410X</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007252">Influenza Vaccines</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007722" MajorTopicYN="Y">Health Knowledge, Attitudes, Practice</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006282" MajorTopicYN="N">Health Personnel</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016867" MajorTopicYN="Y">Immunocompromised Host</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007252" MajorTopicYN="N">Influenza Vaccines</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009426" MajorTopicYN="N" Type="Geographic">Netherlands</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010353" MajorTopicYN="Y">Patient Education as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017410" MajorTopicYN="N">Practice Guidelines as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D036301" MajorTopicYN="N">Qualitative Research</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012107" MajorTopicYN="N">Research Design</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D062606" MajorTopicYN="N">Tertiary Care Centers</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014611" MajorTopicYN="N">Vaccination</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Immunisation</Keyword><Keyword MajorTopicYN="Y">Immunocompromised host</Keyword><Keyword MajorTopicYN="Y">Immunosuppression</Keyword><Keyword MajorTopicYN="Y">Mixed method</Keyword><Keyword MajorTopicYN="Y">Vaccine uptake</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>08</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2018</Year><Month>12</Month><Day>21</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>01</Month><Day>23</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>2</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>8</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>2</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">30739793</ArticleId><ArticleId IdType="pii">S0264-410X(19)30160-4</ArticleId><ArticleId IdType="doi">10.1016/j.vaccine.2019.01.075</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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