Correlates of general practitioners' recommendations to patients regarding vaccination for the 2009-2010 pandemic influenza (A/H1N1) in France: Implications for future vaccination campaigns

Background: General practitioners' (GPs) recommendations to their patients regarding influenza vaccination is a key determinant of patient uptake of influenza vaccination. Objectives: To study factors associated with GPs' recommendations regarding pandemic vaccination (pvaccination) to adults <= 65 years of age (hereafter referred to as adults) at risk and not at risk of severe complications of the 2009-2010 A/H1N1 influenza. Patients/Methods: National cross-sectional survey of 1431 French GPs. Pvaccination recommendations by GPs to adults were studied according to three categories: recommended pvaccination to at-risk adults only; recommended pvaccination to all adults; recommended against pvaccination or did not provide any advice to any adult. Results: GPs were more likely to recommend pvaccination to at-risk than not-at-risk adults (73.4% vs 40.1%,p < 0.01). GPs who consulted official sources of information rather than news media during the pandemic were more likely to recommend pvaccination to at-risk adults only (OR = 1.78; CI 95% = 1.27-2.48) and to all adults (OR = 2.03; CI 95% = 1.42-2.92) than other GPs. GPs' unfavorable perceptions of the risk/efficacy balance of the pandemic vaccine (pvaccine) together with their perceptions of the low severity of the disease were negatively associated with recommending pvaccination. Hospitalization of GPs' patients because of the influenza was specifically associated with pvaccine recommendation to all adults (OR = 2.81; Cl 95% = 1.98-3.99) but not with pvaccine recommendation to at-risk adults only. Conclusion: In the pandemic context, GPs' perceptions of disease severity and the risk/efficacy balance of the pvaccine were the major determinants of French GPs recommending pvaccination or not. To increase the general public's acceptability of vaccination policies, GPs should be adequately informed about the course of the epidemics and the safety of the vaccine. (C) 2014 Elsevier Ltd. All rights reserved.