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Gobert C, Semaille P, Van der Schueren T, Verger P, Dauby N. Prevalence and Determinants of Vaccine Hesitancy and Vaccines Recommendation Discrepancies among General Practitioners in French-Speaking Parts of Belgium. Vaccines (Basel) 2021; 9:vaccines9070771. [PMID: 34358187 PMCID: PMC8310255 DOI: 10.3390/vaccines9070771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/01/2021] [Accepted: 07/06/2021] [Indexed: 12/11/2022] Open
Abstract
General practitioners (GPs) play a critical role in patient acceptance of vaccination. Vaccine hesitancy (VH) is a growing phenomenon in the general population but also affects GPs. Few data exist on VH among GPs. The objectives of this analysis of a population of GPs in the Belgian Wallonia-Brussels Federation (WBF) were to: (1) determine the prevalence and the features of VH, (2) identify the correlates, and (3) estimate the discrepancy in vaccination’s behaviors between the GPs’ children and the recommendations made to their patients. An online survey was carried out among the population of general practitioners practicing in the WBF between 7 January and 18 March 2020. A hierarchical cluster analysis was carried out based on various dimensions of vaccine hesitancy: perception of the risks and the usefulness of vaccines as well as vaccine recommendations for their patients. A total of 251 GPs answered the survey. The average percentage of moderate to high vaccine hesitancy was 50.6%. Three factors were independently associated with increased risk of vaccine hesitancy: an age <50 years old, having no children, and having no contact with selected vaccine-preventable disease (measles, complicated influenza, chronic hepatitis B (HBV), bacterial meningitis, or cervical cancer) in the past 5 years. VH was associated with controversies on vaccines’ safety. GPs who had vaccinated their children against six diseases (MMR, meningococcus C (MenC), HBV, and HPV) tended not to recommend the same vaccines to their patients. Among GPs with all children vaccinated against HBV, only 37.5% recommended catch-up HBV immunization to their patients. In this small cohort of GP, moderate to high VH was associated with controversies on vaccines’ safety and with specific personal characteristics (age <50, no children, and no recent experience with a serious VPD). As previously reported, GPs have different vaccine prescription attitude toward their patients and children. These findings should be confirmed in larger cohorts.
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Affiliation(s)
- Cathy Gobert
- Department of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), 1000 Bruxelles, Belgium;
| | - Pascal Semaille
- Department of General Medicine, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium;
| | | | - Pierre Verger
- Southeastern Health Regional Observatory (ORS PACA), 13005 Marseille, France;
| | - Nicolas Dauby
- Department of Infectious Diseases, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), 1000 Bruxelles, Belgium;
- School of Public Health, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
- Institute for Medical Immunology, Université Libre de Bruxelles (ULB), 1070 Bruxelles, Belgium
- Correspondence:
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A Systematic Review of the Current Hepatitis B Viral Infection and Hepatocellular Carcinoma Situation in Mediterranean Countries. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7027169. [PMID: 32626758 PMCID: PMC7305551 DOI: 10.1155/2020/7027169] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/04/2020] [Accepted: 02/22/2020] [Indexed: 12/13/2022]
Abstract
Viral hepatitis B is a global public health problem affecting nearly two billion subjects; 3.3% of whom are from the WHO (World Health Organization) Eastern Mediterranean Region (EMRO). It induces both acute and chronic hepatic disorders with subsequent liver cirrhosis and hepatocellular carcinoma (HCC) in a considerable percentage of patients based on the age of exposure. In this review, hepatitis B virus (HBV) and HCC prevalence, distribution and prevalence of different genotypes, and male/female infection frequencies in relation to the vaccination status in the Mediterranean countries were reported. Study Design. This systematic review describes the prevalence of hepatitis B infection, genotype distribution of hepatitis B virus, and prevalence and incidence of hepatocellular carcinoma in Mediterranean countries belonging to three different continents: Southern Europe (Spain, France, Italy, Croatia, and Greece), North Africa (Morocco, Algeria, Tunisia, Libya, and Egypt), and the Near East region (Syria, Lebanon, Turkey, Israel, and Palestine). We tried to collect new data from electronic databases: PubMed, ScienceDirect, ResearchGate, Google Scholar, and public health reports between 1980 and 2019. For each publication, we recorded reference, publication year, study characteristics (date, locations, sample size, and study population), and participant characteristics (population group, year, age, and sex). No language limitation was imposed, and articles or reports from non-peer-reviewed sources were not considered for this analysis. The main keywords were HBV prevalence, hepatitis B infection, HBV genotype, and HCC. Inclusion and Exclusion Criteria. Healthy population-based studies included the following sample populations: (i) voluntary blood donors, (ii) pregnant women, (iii) community studies, (iv) hemodialysis patients, (v) hospitalized patients, (vi) healthcare workers, (vii) sex workers, (viii) drug abusers, and (ix) prisoners. We excluded studies from the following special groups who were assumed to be at a special high risk: patients from sexually transmitted disease clinics and thalassemia clinics and professional or paid blood donors.
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Lin CC, Shih CT, Lee CH, Ku MK, Huang YL. Seroepidemiology of Hepatitis B Virus Infection in Native and Immigrant Pregnant Women: A 20-Year Retrospective Study in Taiwan. Am J Trop Med Hyg 2020; 101:899-904. [PMID: 31392948 DOI: 10.4269/ajtmh.19-0088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Universal immunoprophylaxis against hepatitis B virus (HBV) is regarded as a key element to prevent perinatal HBV infection. The aim of the present study was to investigate the changes in the hepatitis B surface antigen (HBsAg)- and hepatitis B envelope antigen (HBeAg)-positive rates in native and immigrant pregnant women, to realize the impact of immigrants, and to identify any weaknesses 30 years after the implementation of hepatitis B vaccination in Taiwan. A total of 20,020 test results of HBsAg and HBeAg in pregnant women-2,915 (14.6%) immigrant women and 17,105 native Taiwanese-from 1996 to 2015 were analyzed for changes during this 20-year retrospective cohort study. Native Taiwanese have a higher HBsAg-positive rate than immigrant women (P < 0.001). However, the HBsAg-positive rates decreased by 0.6% per year among native women, but did not decrease significantly (only by 0.18% per year) among immigrant women. The overall HBsAg-positive rate remained at high levels, 4.8% in the year 2015. The HBeAg-positive rate decreased significantly, by 0.22% per year, in the total women as well as by 0.23% per year in the native women (all P < 0.001); by contrast, the HBeAg-positive rate in immigrants decreased at a slower rate (0.10% per year), without a significant decreasing trend (P = 0.300). Higher HBeAg (+)/HBsAg (+) rate was found for the immigrants than for the native women (P < 0.001). To quickly and effectively lower the risk of vertical transmission, new approaches combined with vaccination may be needed in the post-immunization era.
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Affiliation(s)
- Ching-Chiang Lin
- Department of Education and Research, Fooyin University Hospital, Pingtung, Taiwan.,Department of Medical Laboratory Science and Biotechnology, Fooyin University, Kaohsiung, Taiwan
| | - Ching-Tang Shih
- Department of Family Medicine, Fooyin University Hospital, Pingtung, Taiwan
| | - Chien-Hung Lee
- Department of Public Health and Environmental Medicine Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Kun Ku
- Department of Internal Medicine, Fooyin University Hospital, Pingtung, Taiwan
| | - Yeou-Lih Huang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Chemistry, National Sun Yat-sen University, Kaohsiung, Taiwan.,Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
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Dutilleul A, Morel J, Schilte C, Launay O, Autran B, Béhier JM, Borel T, Bresse X, Chêne G, Courcier S, Dufour V, Faurisson F, Gagneur A, Gelpi O, Gérald F, Kheloufi F, Koeck JL, Lamarque-Garnier V, Lery T, Ménin G, Molimard M, Opinel A, Roger C, Rouby F, Schuck S, Simon L, Soubeyrand B, Truchet MC. How to improve vaccine acceptability (evaluation, pharmacovigilance, communication, public health, mandatory vaccination, fears and beliefs). Therapie 2019; 74:131-140. [DOI: 10.1016/j.therap.2018.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022]
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Dutilleul A, Morel J, Schilte C, Launay O, Autran B, Béhier JM, Borel T, Bresse X, Chêne G, Courcier S, Dufour V, Faurisson F, Gagneur A, Gelpi O, Gérald F, Kheloufi F, Koeck JL, Lamarque-Garnier V, Lery T, Ménin G, Molimard M, Opinel A, Roger C, Rouby F, Schuck S, Simon L, Soubeyrand B, Truchet MC. Comment améliorer l’acceptabilité vaccinale (évaluation, pharmacovigilance, communication, santé publique, obligation vaccinale, peurs et croyances). Therapie 2019; 74:119-129. [DOI: 10.1016/j.therap.2018.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Aba YT, Gagneux-Brunon A, Andrillat C, Fouilloux P, Daoud F, Defontaine C, Lucht F, Botelho-Nevers E. Travel medicine consultation: An opportunity to improve coverage for routine vaccinations. Med Mal Infect 2018; 49:257-263. [PMID: 30583868 DOI: 10.1016/j.medmal.2018.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 03/05/2018] [Accepted: 11/20/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Travelers may be responsible for the spread of vaccine-preventable diseases upon return. Travel physicians and family physicians may play a role in checking and updating vaccinations before traveling. Our aim was to evaluate the vaccine coverage for mandatory and recommended vaccination in travelers attending a travel medicine clinic (TMC). METHODS Vaccine coverage was measured using the current French immunization schedule as reference for correct immunization, in travelers providing a vaccination certificate during the TMC visit (university hospital of Saint-Étienne), between August 1, 2013 and July 31, 2014. RESULTS In total, 2336 travelers came to the TMC during the study period. Among the 2019 study participants, only 1216 (60.3%) provided a vaccination certificate. Travelers who provided a vaccination certificate were significantly younger than travelers who did not (mean age: 34.8±17.8 vs. 46±18.4 years, P<0.005) and were less likely to be Hajj pilgrims. Vaccine coverage against Tetanus, Diphtheria, and Poliomyelitis (Td/IPV vaccine) was 91.8%, 78.6% against Measles, Mumps, and Rubella (MMR), and 59.4% against Viral Hepatitis B (HBV). BCG vaccine coverage was 71.9%. Older travelers were less likely to be correctly vaccinated, except against HBV as vaccinated travelers were significantly older than unvaccinated travelers. CONCLUSION Obtaining information about immunization in travelers is difficult. Coverage for routine vaccines should be improved in this population. Travel medicine consultations could be the opportunity to vaccinate against MMR, HBV, and Td/IPV.
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Affiliation(s)
- Y T Aba
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France; Service de santé publique et de maladies infectieuses, université Alassane Ouattara, Bouaké, Côte d'Ivoire; Groupe immunité des muqueuses et agents Pathogènes - GIMAP EA 3064, université de Saint-Étienne, Université de Lyon, 42270 Saint-Priest-en-Jarez, France
| | - A Gagneux-Brunon
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France; Inserm, CIC 1408, 42055 Saint-Étienne, France; Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), 75679 Paris, France; Groupe immunité des muqueuses et agents Pathogènes - GIMAP EA 3064, université de Saint-Étienne, Université de Lyon, 42270 Saint-Priest-en-Jarez, France.
| | - C Andrillat
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - P Fouilloux
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France; Inserm, CIC 1408, 42055 Saint-Étienne, France; Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), 75679 Paris, France
| | - F Daoud
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - C Defontaine
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - F Lucht
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France; Inserm, CIC 1408, 42055 Saint-Étienne, France; Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), 75679 Paris, France; Groupe immunité des muqueuses et agents Pathogènes - GIMAP EA 3064, université de Saint-Étienne, Université de Lyon, 42270 Saint-Priest-en-Jarez, France
| | - E Botelho-Nevers
- Service des maladies infectieuses et tropicales, Centre de vaccinations internationales et conseils aux voyageurs, CHU de Saint-Étienne, 42055 Saint-Étienne, France; Inserm, CIC 1408, 42055 Saint-Étienne, France; Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), 75679 Paris, France; Groupe immunité des muqueuses et agents Pathogènes - GIMAP EA 3064, université de Saint-Étienne, Université de Lyon, 42270 Saint-Priest-en-Jarez, France
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Wiyeh AB, Cooper S, Nnaji CA, Wiysonge CS. Vaccine hesitancy ‘outbreaks’: using epidemiological modeling of the spread of ideas to understand the effects of vaccine related events on vaccine hesitancy. Expert Rev Vaccines 2018; 17:1063-1070. [DOI: 10.1080/14760584.2018.1549994] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Alison B. Wiyeh
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Sara Cooper
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Chukwudi A. Nnaji
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Charles S. Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Boyd A, Bottero J, Carrat F, Gozlan J, Rougier H, Girard PM, Lacombe K. Testing for hepatitis B virus alone does not increase vaccine coverage in non-immunized persons. World J Gastroenterol 2017; 23:7037-7046. [PMID: 29097876 PMCID: PMC5658321 DOI: 10.3748/wjg.v23.i38.7037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 09/11/2017] [Accepted: 09/19/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To determine whether hepatitis B virus (HBV)-testing could serve as a gateway to vaccinate non-immunized individuals in a low-prevalent country.
METHODS Non-immunized subjects participating in a multi-center, HBV-testing campaign in Paris, France were identified and contacted via telephone 3-9 mo after testing in order to determine vaccination status. Vaccination coverage was evaluated in per-protocol (for all respondents) and intent-to-treat analysis (assuming all non-responders did not vaccinate).
RESULTS In total, 1215/4924 (24.7%) enrolled subjects with complete HBV serology were identified as non-immunized and eligible for analysis. There were 99/902 successfully contacted subjects who had initiated HBV vaccination after screening: per-protocol, 11.0% (95%CI: 9.0-13.2); intent-to-treat, 8.2% (95%CI: 6.7-9.8). In multivariable analysis, vaccination was more likely to be initiated in individuals originating from moderate or high HBV-endemic countries (P < 0.001), patients with limited healthcare coverage (P = 0.01) and men who have sex with men (P = 0.02). When asked about the reasons for not initiating HBV vaccination, the most frequent response was “will be vaccinated later” (33.4%), followed by “did not want to vaccinate” (29.8%), and “vaccination was not proposed by the physician” (21.5%). Sub-group analysis indicated a stark contrast in vaccination coverage across centers, ranging from 0%-56%.
CONCLUSION HBV-vaccination after HBV screening was very low in this study, which appeared largely attributed to physician-patient motivation towards vaccination. Increased vaccination coverage might be achieved by emphasizing its need at the organizational level.
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Affiliation(s)
- Anders Boyd
- Institute Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), INSERM, Sorbonne Universités, F-75012 Paris, France
| | - Julie Bottero
- Institute Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), INSERM, Sorbonne Universités, F-75012 Paris, France
- Service de maladies infectieuses, Hôpital Saint-Antoine, AP-HP, F-75012 Paris, France
| | - Fabrice Carrat
- Institute Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), INSERM, Sorbonne Universités, F-75012 Paris, France
- Département de santé publique, Hôpital Saint-Antoine, AP-HP, F-75012 Paris, France
| | - Joël Gozlan
- Laboratoire de Virologie, Hôpital Saint-Antoine, AP-HP, F-75012 Paris, France
- INSERM, UMR_S1135 CIMI, Paris F-75013, France
| | - Hayette Rougier
- Service de maladies infectieuses, Hôpital Saint-Antoine, AP-HP, F-75012 Paris, France
| | - Pierre-Marie Girard
- Institute Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), INSERM, Sorbonne Universités, F-75012 Paris, France
- Service de maladies infectieuses, Hôpital Saint-Antoine, AP-HP, F-75012 Paris, France
| | - Karine Lacombe
- Institute Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), INSERM, Sorbonne Universités, F-75012 Paris, France
- Service de maladies infectieuses, Hôpital Saint-Antoine, AP-HP, F-75012 Paris, France
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