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Low acceptability of A/H1N1 pandemic vaccination in French adult population: did public health policy fuel public dissonance?

Identifieur interne : 000199 ( France/Analysis ); précédent : 000198; suivant : 000200

Low acceptability of A/H1N1 pandemic vaccination in French adult population: did public health policy fuel public dissonance?

Auteurs : Michaël Schwarzinger [France] ; Rémi Flicoteaux [France] ; Sébastien Cortarenoda [France] ; Yolande Obadia [France] ; Jean-Paul Moatti [France]

Source :

RBID : Hal:inserm-00636172

Abstract

BACKGROUND: 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. METHODOLOGY/PRINCIPAL FINDINGS: 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. CONCLUSIONS/SIGNIFICANCE: 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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DOI: 10.1371/journal.pone.0010199


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Hal:inserm-00636172

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<country>France</country>
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<settlement type="city">Marseille</settlement>
<region type="region" nuts="2">Provence-Alpes-Côte d'Azur</region>
</placeName>
<orgName type="university">Université d'Aix-Marseille</orgName>
</affiliation>
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<author>
<name sortKey="Obadia, Yolande" sort="Obadia, Yolande" uniqKey="Obadia Y" first="Yolande" last="Obadia">Yolande Obadia</name>
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<idno type="IdRef">13143697X</idno>
<idno type="RNSR">200817366W</idno>
<orgName>Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale</orgName>
<orgName type="acronym">SESSTIM - U912 INSERM - Aix Marseille Univ - IRD</orgName>
<date type="start">2012-01-01</date>
<desc>
<address>
<addrLine>Faculté de Médecine - Site Timone - 27 Bd Jean Moulin 13385 – Marseille Cedex 05</addrLine>
<country key="FR"></country>
</address>
<ref type="url">https://sesstim.univ-amu.fr/page/contact</ref>
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<tutelle active="#struct-67872" type="direct">
<org type="institution" xml:id="struct-67872" status="VALID">
<orgName>Institut de Recherche pour le Développement</orgName>
<orgName type="acronym">IRD</orgName>
<desc>
<address>
<addrLine>SiègeLe Sextant 44, bd de DunkerqueCS 9000913572 Marseille cedex 02</addrLine>
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<ref type="url">http://www.ird.fr/</ref>
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<org type="institution" xml:id="struct-198056" status="VALID">
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<idno type="ISNI">0000 0001 2176 4817</idno>
<orgName>Aix Marseille Université</orgName>
<orgName type="acronym">AMU</orgName>
<date type="start">2012-01-01</date>
<desc>
<address>
<addrLine>Aix-Marseille UniversitéJardins du Pharo58 Boulevard Charles Livon13284 Marseille cedex 7</addrLine>
<country key="FR"></country>
</address>
<ref type="url">http://www.univ-amu.fr/</ref>
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</org>
</tutelle>
<tutelle name="U912" active="#struct-303623" type="direct">
<org type="institution" xml:id="struct-303623" status="VALID">
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<orgName>Institut National de la Santé et de la Recherche Médicale</orgName>
<orgName type="acronym">INSERM</orgName>
<desc>
<address>
<addrLine>101, rue de Tolbiac, 75013 Paris </addrLine>
<country key="FR"></country>
</address>
<ref type="url">http://www.inserm.fr</ref>
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<country>France</country>
<placeName>
<settlement type="city">Marseille</settlement>
<region type="region" nuts="2">Provence-Alpes-Côte d'Azur</region>
</placeName>
<orgName type="university">Université d'Aix-Marseille</orgName>
</affiliation>
</author>
<author>
<name sortKey="Moatti, Jean Paul" sort="Moatti, Jean Paul" uniqKey="Moatti J" first="Jean-Paul" last="Moatti">Jean-Paul Moatti</name>
<affiliation wicri:level="1">
<hal:affiliation type="laboratory" xml:id="struct-540465" status="OLD">
<idno type="IdRef">13143697X</idno>
<idno type="RNSR">200817366W</idno>
<orgName>Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale</orgName>
<orgName type="acronym">SESSTIM - U912 INSERM - Aix Marseille Univ - IRD</orgName>
<date type="start">2012-01-01</date>
<desc>
<address>
<addrLine>Faculté de Médecine - Site Timone - 27 Bd Jean Moulin 13385 – Marseille Cedex 05</addrLine>
<country key="FR"></country>
</address>
<ref type="url">https://sesstim.univ-amu.fr/page/contact</ref>
</desc>
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<relation active="#struct-67872" type="direct"></relation>
<relation active="#struct-198056" type="direct"></relation>
<relation name="U912" active="#struct-303623" type="direct"></relation>
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<tutelle active="#struct-67872" type="direct">
<org type="institution" xml:id="struct-67872" status="VALID">
<orgName>Institut de Recherche pour le Développement</orgName>
<orgName type="acronym">IRD</orgName>
<desc>
<address>
<addrLine>SiègeLe Sextant 44, bd de DunkerqueCS 9000913572 Marseille cedex 02</addrLine>
<country key="FR"></country>
</address>
<ref type="url">http://www.ird.fr/</ref>
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<org type="institution" xml:id="struct-198056" status="VALID">
<idno type="IdRef">15863621X</idno>
<idno type="ISNI">0000 0001 2176 4817</idno>
<orgName>Aix Marseille Université</orgName>
<orgName type="acronym">AMU</orgName>
<date type="start">2012-01-01</date>
<desc>
<address>
<addrLine>Aix-Marseille UniversitéJardins du Pharo58 Boulevard Charles Livon13284 Marseille cedex 7</addrLine>
<country key="FR"></country>
</address>
<ref type="url">http://www.univ-amu.fr/</ref>
</desc>
</org>
</tutelle>
<tutelle name="U912" active="#struct-303623" type="direct">
<org type="institution" xml:id="struct-303623" status="VALID">
<idno type="IdRef">026388278</idno>
<orgName>Institut National de la Santé et de la Recherche Médicale</orgName>
<orgName type="acronym">INSERM</orgName>
<desc>
<address>
<addrLine>101, rue de Tolbiac, 75013 Paris </addrLine>
<country key="FR"></country>
</address>
<ref type="url">http://www.inserm.fr</ref>
</desc>
</org>
</tutelle>
</tutelles>
</hal:affiliation>
<country>France</country>
<placeName>
<settlement type="city">Marseille</settlement>
<region type="region" nuts="2">Provence-Alpes-Côte d'Azur</region>
</placeName>
<orgName type="university">Université d'Aix-Marseille</orgName>
</affiliation>
</author>
</analytic>
<idno type="DOI">10.1371/journal.pone.0010199</idno>
<series>
<title level="j">PLoS ONE</title>
<idno type="ISSN">1932-6203</idno>
<imprint>
<date type="datePub">2010</date>
</imprint>
</series>
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<front>
<div type="abstract" xml:lang="en">
<p>BACKGROUND: 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. METHODOLOGY/PRINCIPAL FINDINGS: 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. CONCLUSIONS/SIGNIFICANCE: 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.</p>
</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>France</li>
</country>
<region>
<li>Provence-Alpes-Côte d'Azur</li>
</region>
<settlement>
<li>Marseille</li>
</settlement>
<orgName>
<li>Université d'Aix-Marseille</li>
</orgName>
</list>
<tree>
<country name="France">
<region name="Provence-Alpes-Côte d'Azur">
<name sortKey="Schwarzinger, Michael" sort="Schwarzinger, Michael" uniqKey="Schwarzinger M" first="Michaël" last="Schwarzinger">Michaël Schwarzinger</name>
</region>
<name sortKey="Cortarenoda, Sebastien" sort="Cortarenoda, Sebastien" uniqKey="Cortarenoda S" first="Sébastien" last="Cortarenoda">Sébastien Cortarenoda</name>
<name sortKey="Flicoteaux, Remi" sort="Flicoteaux, Remi" uniqKey="Flicoteaux R" first="Rémi" last="Flicoteaux">Rémi Flicoteaux</name>
<name sortKey="Moatti, Jean Paul" sort="Moatti, Jean Paul" uniqKey="Moatti J" first="Jean-Paul" last="Moatti">Jean-Paul Moatti</name>
<name sortKey="Obadia, Yolande" sort="Obadia, Yolande" uniqKey="Obadia Y" first="Yolande" last="Obadia">Yolande Obadia</name>
</country>
</tree>
</affiliations>
</record>

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