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Dumesnil H, Lutaud R, Bellon-Curutchet J, Deffontaines A, Verger P. Dealing with the doctor shortage: a qualitative study exploring French general practitioners' lived experiences, difficulties, and adaptive behaviours. Fam Pract 2024:cmae017. [PMID: 38521970 DOI: 10.1093/fampra/cmae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/25/2024] Open
Abstract
CONTEXT The shortage of general practitioners (GPs) is a growing concern in Europe, especially in France. This problem is likely to continue until the end of the 2020s. OBJECTIVES To study the GPs' perceptions of access to care in medically underserved areas (i.e. with low physician density), its consequences on their working conditions, and how they cope with the resulting difficulties. METHODS Semi-structured individual interviews were conducted between May and August 2021 of 29 GPs practising in areas of southeastern France with a low physician density or at risk of a doctor shortage. Purposive sampling was used to include profiles of diverse physicians and diverse rural and urban areas. The interviews, conducted with an interview guide, were transcribed and analysed thematically. RESULTS The participants described a serious degradation of access to care in their areas. These issues also concerned urban areas, where they were, according to the participants, underrecognized. The participants' workloads were rising, at a rate often perceived as unsustainable: many participants, including the youngest group, reported they were exhausted. Their principal source of dissatisfaction was their impression that they could not do their work correctly. Participants reported that these difficulties required them to improvise and adapt without any official or formal method to keep their practice manageable. CONCLUSION These GPs were worried about the future of their profession and their patients. They expected strong measures by public policymakers and officials, but paradoxically seemed to have little interest in the solutions these officials are promoting.
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Affiliation(s)
- Hélène Dumesnil
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Romain Lutaud
- Faculté des Sciences Médicales et Paramédicales, Département Universitaire de Médecine Générale (DUMG), Aix Marseille Université, Marseille, France
| | - Julien Bellon-Curutchet
- Faculté des Sciences Médicales et Paramédicales, Département Universitaire de Médecine Générale (DUMG), Aix Marseille Université, Marseille, France
| | - Aliénor Deffontaines
- Faculté des Sciences Médicales et Paramédicales, Département Universitaire de Médecine Générale (DUMG), Aix Marseille Université, Marseille, France
| | - Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
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Peretti-Watel P, Verger P, Ward JK. To understand mRNA vaccine hesitancy, stop calling the public anti-science. Nat Med 2024:10.1038/s41591-024-02816-y. [PMID: 38413729 DOI: 10.1038/s41591-024-02816-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Affiliation(s)
- Patrick Peretti-Watel
- Unité des Virus Émergents (UVE), Aix-Marseille Univ, Università di Corsica, IRD 190, INSERM 1207, IRBA, Marseille, France
- ORS Paca, Southeastern Health Regional Observatory, Marseille, France
| | - Pierre Verger
- ORS Paca, Southeastern Health Regional Observatory, Marseille, France
| | - Jeremy K Ward
- CERMES3 (INSERM, CNRS, EHESS, Université de Paris), Villejuif, France.
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Peretti-Watel P, Fressard L, Giry B, Verger P, Ward JK. Social Stigma and COVID-19 Vaccine Refusal in France. J Health Polit Policy Law 2024:11186095. [PMID: 38324348 DOI: 10.1215/03616878-11186095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
CONTEXT In 2021, French health authorities strongly promoted the vaccination against Covid-19. We assumed that refusing this vaccine became a 'stigma', and we investigated potential 'public stigma' toward unvaccinated people among the French population. METHODS A representative sample of the French adult population (N = 2,015) completed an online questionnaire in September 2021. We focused on participants who were already vaccinated against Covid-19, or intended to get vaccinated (N = 1,742). A cluster analysis was used to obtain contrasted attitudinal profiles, and we investigated associated factors with logistic regressions. FINDINGS Regarding attitudes toward unvaccinated people, several pejorative statements were supported by a majority of respondents, and a significant minority also endorsed social rejection attitudes. We found four contrasted attitudinal profiles: Moral condemnation only (32% of respondents), Full stigma (26%), No stigma (26%) and Stigma rejection (16%). Early vaccination, civic motives for it, faith in science, rejection of political extremes and being 65 or over were the main factors of stigmatizing attitudes toward unvaccinated people. CONCLUSIONS We found some evidence of stigmatization toward unvaccinated people, but further research is needed, especially to investigate perceived stigmatization among them. We discussed our results in reference with the concept of 'Folk Devils', and from a public health perspective.
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Garrison A, Fressard L, Mitilian E, Gosselin V, Berthiaume P, Casanova L, Gagneur A, Verger P. Motivational interview training improves self-efficacy of GP interns in vaccination consultations: A study using the Pro-VC-Be to measure vaccine confidence determinants. Hum Vaccin Immunother 2023; 19:2163809. [PMID: 36703495 PMCID: PMC10012912 DOI: 10.1080/21645515.2022.2163809] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Immunization-specific motivational interviewing (MI), a patient-centered communication style used to encourage internal motivation for attitudinal and behavioral change, can provide healthcare professionals (HCPs) with the skills and practice required to respond to patients' doubts and concerns related to vaccines. We sought to assess the impact of an MI-training of General Practitioner (GP) interns on the psychosocial determinants of their vaccine confidence and behaviors. French GP interns participated in a virtual three-day MI-workshop in southeastern France. We used the validated Pro-VC-Be questionnaire - before and after the MI-workshop spanning over three months - to measure the evolution of these determinants. Scores before and after workshop trainings were compared in pairs. Participants' scores for commitment to vaccination (+10.5 ± 20.5, P = .001), perceived self-efficacy (+36.0 ± 25.8, P < .0001), openness to patients (+18.7 ± 17.0, P < .0001), and trust in authorities (+9.5 ± 17.2, P = 0.01) significantly increased after the training sessions, but not the score for confidence in vaccines (+1.5 ± 11.9, P = .14). The effect sizes of the four score improvements were moderate to large, with self-efficacy and openness to patients having the largest effect sizes (P = .83 and 0.78, respectively). This study provides evidence that certain determinants of overall vaccine confidence in HCPs, reflected respectively in the openness to patients and self-efficacy scores of the Pro-VC-Be, improve after immunization MI-training workshops. Incorporating immunization-specific MI-training in the curriculum for HCPs could improve several necessary skills to improve HCP-patient relationships and be useful for vaccination and other healthcare services.
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Affiliation(s)
- Amanda Garrison
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
| | - Lisa Fressard
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
| | - Eva Mitilian
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France.,Faculté des Sciences Médicales et Paramédicales, Département Universitaire de Médecine Générale (DUMG), Aix Marseille Université, Marseille, France
| | - Virginie Gosselin
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | | | - Ludovic Casanova
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France.,Faculté des Sciences Médicales et Paramédicales, Département Universitaire de Médecine Générale (DUMG), Aix Marseille Université, Marseille, France
| | - Arnaud Gagneur
- Centre de Recherche du Centre Hospitalier, Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.,Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Pierre Verger
- Faculté des Sciences Médicales et Paramédicales, Observatoire Régional de la Santé (ORS) PACA, Marseille, France
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Brosset E, Fressard L, Cogordan C, Bocquier A, Annequin M, Bourrelly M, Constance J, Michels D, Mora M, Morel S, Oliveri C, Maradan G, Berenger C, Spire B, Verger P. Gradient of vaccine hesitancy among French men having sex with men: An electronic cross-sectional survey in 2022. Hum Vaccin Immunother 2023; 19:2293489. [PMID: 38093684 PMCID: PMC10730215 DOI: 10.1080/21645515.2023.2293489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
In developed countries, vaccinations against hepatitis B (HBV), hepatitis A (HAV), and human papillomavirus (HPV) are often recommended to men who have sex with men (MSM) because of the risky sexual practices in which some engage. Vaccine coverage against these diseases is not optimal in France, probably due in part to vaccine hesitancy (VH). The overall aim of this survey among MSM was to estimate the prevalence of different grades of VH for these vaccines as well as of general VH (toward any vaccine). The specific objectives were to study the sociodemographic correlates of MSM specific and general VH and its association with vaccine uptake. A cross-sectional electronic survey (February-August 2022) collected information from 3,730 French MSM about their perceptions of HBV, HAV, and HPV and their related vaccines, to construct "specific VH" variables. Information about their past vaccination behaviors for any vaccine was used to construct a "general VH" variable, based on the World Health Organization definition. Almost 90% of MSM showed moderate or high specific VH for HBV, HAV, and/or HPV, and 54% general VH. A higher education level and comfortable financial situation were associated with lower grades of specific and general VH. Younger age was associated with less frequent specific VH and more frequent general VH. Specific VH, versus general, was more strongly associated with frequent self-reported non-vaccination against these three disease. Addressing their concerns about vaccines, improving their knowledge of vaccine-preventable sexually transmitted infections, and motivating them to get vaccinated are public health priorities.
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Affiliation(s)
- Emeline Brosset
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Lisa Fressard
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Chloé Cogordan
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Aurélie Bocquier
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- Université de Lorraine, APEMAC , Nancy, France
| | - Margot Annequin
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Michel Bourrelly
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Jean Constance
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - David Michels
- AIDES, Pantin, France
- Laboratoire de recherche communautaire, Coalition PLUS, Pantin, France
| | - Marion Mora
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | | | - Camilla Oliveri
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Gwenaëlle Maradan
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Cyril Berenger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Bruno Spire
- INSERM, IRD, SESSTIM, ISSPAM, Aix Marseille University, Marseille, France
| | - Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
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6
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Barré T, Di Beo V, Roux P, Mourad A, Verger P, Fressard L, Herault T, Buyck JF, Beck F, Carrieri P. Screening for alcohol use in primary care: assessing French general practitioner practices. Alcohol Alcohol 2023; 58:672-682. [PMID: 37818974 DOI: 10.1093/alcalc/agad067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/13/2023] Open
Abstract
Alcohol use is a leading risk factor for premature death and disability. To tackle this issue, more systematic and accurate screening for at-risk consumption is needed in healthcare systems, especially by general practitioners (GPs). We assessed the frequency of at-risk consumption screening by GPs in France. We also identified characteristics associated with more frequent screening and greater use of validated screening tools by these healthcare providers. A cross-sectional survey was conducted among a representative sample of French GPs. Multinomial logistic regressions were used to identify factors associated with more frequent screening and greater use of validated screening tools. Response rate was of 73%. Of the 2412 participants, 42.8% screened all their patients systematically and repeatedly, while 48.0% never used standardized tools to screen potentially at-risk patients. Among other characteristics, being aware of and using the "early identification and brief intervention" screening strategy, and feeling absolutely comfortable talking with patients about reducing or stopping their alcohol use, were both associated with more frequent screening and use of standardized tools. Our results on at-risk alcohol use screening highlight an improvement over data from previous studies. Nevertheless, better training of French GPs in good alcohol screening practices-specifically, increased screening frequency and greater use of standardized tools-may improve identification of at-risk patients.
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Affiliation(s)
- Tangui Barré
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
| | - Vincent Di Beo
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
| | - Perrine Roux
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
| | - Abbas Mourad
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
| | - Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Faculté des Sciences Médicales et Paramédicales, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Lisa Fressard
- ORS PACA, Southeastern Health Regional Observatory, Faculté des Sciences Médicales et Paramédicales, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Thomas Herault
- Union Régionale des Médecins Libéraux des Pays de La Loire, 13 rue de la Loire, Bâtiment C2, 44230 Saint Sébastien-sur-Loire, Nantes, France
| | - Jean-François Buyck
- Observatoire Régional de La Santé Des Pays de La Loire, 2 Rue de la Loire, 44200 Nantes, France
| | - François Beck
- Santé Publique France, 12, rue du Val d'Osne 94 415 Saint-Maurice cedex, France
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP), Inserm U1018, Université Paris-Saclay, Université Paris-Sud, Université Versailles Saint-Quentin (UVSQ), 16 Av. Paul Vaillant Couturier, 94800 Villejuif, France
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France
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Verger P, Cogordan C, Fressard L, Gosselin V, Donato X, Biferi M, Verlomme V, Sonnier P, Meur H, Malfait P, Berthiaume P, Ramalli L, Gagneur A. A postpartum intervention for vaccination promotion by midwives using motivational interviews reduces mothers' vaccine hesitancy, south-eastern France, 2021 to 2022: a randomised controlled trial. Euro Surveill 2023; 28:2200819. [PMID: 37733238 PMCID: PMC10515496 DOI: 10.2807/1560-7917.es.2023.28.38.2200819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/17/2023] [Indexed: 09/22/2023] Open
Abstract
BackgroundDespite childhood vaccine mandates imposed in 2018 in France, parental vaccine hesitancy (VH) remains frequent. Interventions in Quebec, Canada, applying motivational interviewing (MI) techniques have successfully reduced parents' VH for childhood immunisations.AimTo determine whether MI intervention for mothers in maternity wards in the days after birth in France could significantly reduce VH, increase intentions to vaccinate (VI) their child at 2 months and reduce VH social inequalities.MethodsWe conducted a parallel-arm multicentre randomised controlled trial from November 2021 to April 2022 to compare impacts of MI performed by MI-trained midwives (intervention) vs a vaccination leaflet (control). We included 733 mothers from two maternity hospitals in south-eastern France, randomly assigned either arm. The validated Parents Attitudes about Childhood Vaccines questionnaire was used before and after MI or leaflet to assess mothers' VH (13 items, 0-100 score) and VI (1 item, 1-10 score). Difference-in-difference (D-I-D) models were used to estimate net impact of MI vs leaflet for the entire sample and stratified by VH and education level.ResultsMotivational interview intervention reduced mothers' VH score by 33% (p < 0.0001) and increased VI by 8% (p < 0.0001); the effect was largest for the highest initial VH levels. D-I-D analyses estimated net VH decrease at 5.8/100 points (p = 0.007) and net VI increase at 0.6/10 points (p = 0.005). Net VH decrease was highest for high initial VH levels and low education levels.ConclusionsOur results show positive effects of MI intervention, and means of its implementation should be investigated in France.
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Affiliation(s)
- Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Chloé Cogordan
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | - Lisa Fressard
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| | | | - Xavier Donato
- Maternity ward, Saint-Joseph Hospital, Marseille, France
| | | | | | - Pierre Sonnier
- Comité Régional d'Education pour la Santé Provence-Alpes-Côte-D'Azur, Marseille, France
| | - Hervé Meur
- Agence Régionale de Santé Provence-Alpes-Côte-D'Azur, Marseille, France
| | - Philippe Malfait
- Santé publique France (French National Public Health Agency), Marseille, France
| | | | - Lauriane Ramalli
- Santé publique France (French National Public Health Agency), Marseille, France
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Khouri C, Larabi A, Verger P, Gauna F, Cracowski JL, Ward JK. Exploring the feelings of being at risk of vaccine related adverse effects: A cross-sectional survey in France. J Psychosom Res 2023; 172:111433. [PMID: 37406414 DOI: 10.1016/j.jpsychores.2023.111433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVES The literature on vaccine hesitancy has widely commented on the various factors leading some to feel particularly at risk of disease infection while others do not. But little attention has been paid to whether we also see such differences regarding people's assessment of their personal vulnerability towards vaccine adverse events (AEs). METHODS We designed two cross-sectional online surveys among representative samples of the French mainland population (n = 2015 and 3087). We asked participants if they felt, more than others, at risk of severe vaccine related side effects and to explain why. We performed two separate mixed effect binomial regressions models: 1) to explore the link between the feeling of being particularly at risk of severe vaccine related AEs and socio-demographic characteristics, source of information, trust in health agencies and partisan orientation; 2) to explore the link between the fear of side effects and vaccine hesitancy. RESULTS We found that 15% of respondents felt to be, more than others, at risk of severe vaccine-related adverse events and that this feeling was associated to negative attitudes to vaccines. This feeling was particularly prevalent among women, those with a lower income, lower educational attainment and lower trust in public health institutions. The vast majority of the reasons given by responders are unrelated to genuine risk factors of vaccine related adverse events. CONCLUSIONS These findings suggest that vaccine hesitancy is at least partly grounded in a feeling of vulnerability towards vaccine adverse events.
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Affiliation(s)
- Charles Khouri
- Pharmacovigilance Unit, Grenoble Alpes University Hospital, Grenoble, France; Grenoble Alpes Univ., HP2 Laboratory, Inserm U1300, Grenoble, France.
| | - Ayoub Larabi
- Pharmacovigilance Unit, Grenoble Alpes University Hospital, Grenoble, France
| | - Pierre Verger
- Observatoire régional de la santé PACA (ORS Paca), Aix-Marseille Université, Marseille, France; VITROME (Aix Marseille Université, IRD, AP-HM, SSA), Marseille, France
| | - Fatima Gauna
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France; Université Paris Cité, CNRS, Inserm, Cermes3, F-94800 Villejuif, France
| | - Jean-Luc Cracowski
- Pharmacovigilance Unit, Grenoble Alpes University Hospital, Grenoble, France; Grenoble Alpes Univ., HP2 Laboratory, Inserm U1300, Grenoble, France
| | - Jeremy K Ward
- VITROME (Aix Marseille Université, IRD, AP-HM, SSA), Marseille, France; Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France; Université Paris Cité, CNRS, Inserm, Cermes3, F-94800 Villejuif, France
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Cogordan C, Fressard L, Ramalli L, Rebaudet S, Malfait P, Dutrey-Kaiser A, Attalah Y, Roy D, Berthiaume P, Gagneur A, Verger P. Motivational interview-based health mediator interventions increase intent to vaccinate among disadvantaged individuals. Hum Vaccin Immunother 2023; 19:2261687. [PMID: 37772602 PMCID: PMC10543359 DOI: 10.1080/21645515.2023.2261687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/19/2023] [Indexed: 09/30/2023] Open
Abstract
Coverage for recommended COVID-19 and diphtheria-tetanus-poliomyelitis (DTP) booster shots is often inadequate, especially among disadvantaged populations. To help health mediators (HMs) involved in outreach programs deal with the problems of vaccine hesitancy (VH) in these groups, we trained them in motivational interviewing (MI). We evaluated the effectiveness of this training among HMs on their MI knowledge and skills (objective 1) and among the interviewees on their vaccination readiness (VR) and intention to get vaccinated or accept a booster against COVID-19 and/or DTP (objective 2). Two MI specialists trained 16 HMs in a two-day workshop in May 2022. The validated MISI questionnaire evaluated HMs' acquisition of MI knowledge and skills (objective 1). Trained HMs offered an MI-based intervention on vaccination to people in disadvantaged neighborhoods of Marseille (France). Those who consented completed a questionnaire before and after the interview to measure VR with the 7C scale and intentions regarding vaccination/booster against COVID-19 and DTP (objective 2). The training resulted in HMs acquiring good MI skills (knowledge, application, self-confidence in using it). HMs enrolled 324 interviewees, 96% of whom completed both questionnaires. VR increased by 6%, and intentions to get vaccinated or update COVID-19 and DTP vaccination increased by 74% and 52% respectively. Nearly all interviewees were very satisfied with the interview, although 21% still had questions about vaccination. HMs assimilated MI principles well. MI use in outreach programs appears to show promise in improving vaccine confidence and intentions among disadvantaged people.
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Affiliation(s)
- Chloé Cogordan
- Southeastern Health Regional Observatory, ORS PACA, Marseille, France
| | - Lisa Fressard
- Southeastern Health Regional Observatory, ORS PACA, Marseille, France
| | - Lauriane Ramalli
- Santé publique France (French National Public Health Agency), Marseille, France
| | - Stanislas Rebaudet
- Hôpital Européen, Marseille, France
- UMR1252 SESSTIM, Aix-Marseille University, Inserm, IRD, ISSPAM, Marseille, France
| | - Philippe Malfait
- Santé publique France (French National Public Health Agency), Marseille, France
| | | | | | - David Roy
- Centre de recherche du CHUS, Sherbrooke, QC, Canada
| | | | - Arnaud Gagneur
- Centre de recherche du CHUS, Sherbrooke, QC, Canada
- Department of Pediatrics, Sherbrooke University, Sherbrooke, QC, Canada
| | - Pierre Verger
- Southeastern Health Regional Observatory, ORS PACA, Marseille, France
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Fasce A, Karlsson L, Verger P, Mäki O, Taubert F, Garrison A, Schmid P, Holford DL, Lewandowsky S, Rodrigues F, Betsch C, Soveri A. Endorsement of alternative medicine and vaccine hesitancy among physicians: A cross-sectional study in four European countries. Hum Vaccin Immunother 2023; 19:2242748. [PMID: 37581343 PMCID: PMC10431744 DOI: 10.1080/21645515.2023.2242748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/13/2023] [Accepted: 07/27/2023] [Indexed: 08/16/2023] Open
Abstract
Vaccine hesitancy has become a threat to public health, especially as it is a phenomenon that has also been observed among healthcare professionals. In this study, we analyzed the relationship between endorsement of complementary and alternative medicine (CAM) and vaccination attitudes and behaviors among healthcare professionals, using a cross-sectional sample of physicians with vaccination responsibilities from four European countries: Germany, Finland, Portugal, and France (total N = 2,787). Our results suggest that, in all the participating countries, CAM endorsement is associated with lower frequency of vaccine recommendation, lower self-vaccination rates, and being more open to patients delaying vaccination, with these relationships being mediated by distrust in vaccines. A latent profile analysis revealed that a profile characterized by higher-than-average CAM endorsement and lower-than-average confidence and recommendation of vaccines occurs, to some degree, among 19% of the total sample, although these percentages varied from one country to another: 23.72% in Germany, 17.83% in France, 9.77% in Finland, and 5.86% in Portugal. These results constitute a call to consider health care professionals' attitudes toward CAM as a factor that could hinder the implementation of immunization campaigns.
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Affiliation(s)
- Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Pierre Verger
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Otto Mäki
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Frederike Taubert
- Institute for Planetary Health Behavior, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Amanda Garrison
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Philipp Schmid
- Institute for Planetary Health Behavior, University of Erfurt, Erfurt, Germany
- Department of Implementation Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn Liu Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychological Science, University of Western Australia, Perth, Australia
- Department of Psychology, University of Potsdam, Postdam, Germany
| | | | - Cornelia Betsch
- Health Communication Working Group, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
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Karlsson LC, Garrison A, Holford D, Fasce A, Lewandowsky S, Taubert F, Schmid P, Betsch C, Rodrigues F, Fressard L, Verger P, Soveri A. Healthcare professionals' attitudes to mandatory COVID-19 vaccination: Cross-sectional survey data from four European countries. Hum Vaccin Immunother 2023; 19:2256442. [PMID: 37724556 PMCID: PMC10512846 DOI: 10.1080/21645515.2023.2256442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023] Open
Abstract
Mandatory vaccinations are widely debated since they restrict individuals' autonomy in their health decisions. As healthcare professionals (HCPs) are a common target group of vaccine mandates, and also form a link between vaccination policies and the public, understanding their attitudes toward vaccine mandates is important. The present study investigated physicians' attitudes to COVID-19 vaccine mandates in four European countries: Finland, France, Germany, and Portugal. An electronic survey assessing attitudes to COVID-19 vaccine mandates and general vaccination attitudes (e.g. perceived vaccine safety, trust in health authorities, and openness to patients) was sent to physicians in the spring of 2022. A total of 2796 physicians responded. Across all countries, 78% of the physicians were in favor of COVID-19 vaccine mandates for HCPs, 49% favored COVID-19 vaccine mandates for the public, and 67% endorsed COVID-19 health passes. Notable differences were observed between countries, with attitudes to mandates found to be more positive in countries where the mandate, or similar mandates, were in effect. The associations between attitudes to mandates and general vaccination attitudes were mostly small to neglectable and differed between countries. Nevertheless, physicians with more positive mandate attitudes perceived vaccines as more beneficial (in Finland and France) and had greater trust in medical authorities (in France and Germany). The present study contributes to the body of research within social and behavioral sciences that support evidence-based vaccination policymaking.
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Affiliation(s)
- Linda C. Karlsson
- Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Amanda Garrison
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Potsdam, Potsdam, Germany
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Frederike Taubert
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Implementation Research, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
| | - Philipp Schmid
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Implementation Research, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
- Centre for Language Studies, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Cornelia Betsch
- Institute for Planetary Health Behavior, Health Communication, University of Erfurt, Erfurt, Germany
- Health Communication Working Group, Implementation Research, Bernhard Nocht Institute for Tropical Medicine, University of Hamburg, Hamburg, Germany
| | | | - Lisa Fressard
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Pierre Verger
- Faculté des Sciences Médicales et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS-PACA), Marseille, France
| | - Anna Soveri
- Department of Clinical Medicine, University of Turku, Turku, Finland
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Gauna F, Verger P, Fressard L, Jardin M, Ward JK, Peretti-Watel P. Vaccine hesitancy about the HPV vaccine among French young women and their parents: a telephone survey. BMC Public Health 2023; 23:628. [PMID: 37005583 PMCID: PMC10066945 DOI: 10.1186/s12889-023-15334-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/28/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND The human papillomavirus (HPV) vaccine reduces the burden of cervical and other cancers. In numerous countries, a slow uptakeof this vaccine persists, calling for a better understanding of the structural factors leading to vaccine acceptation. We aimed to assess the attitudes toward HPV vaccination among its intended public to explore its specific characteristics. METHODS A random cross-sectional telephone survey of the French general population provided data from a sample of 2426 respondents of the target public: the parents of young women and the young women aged 15-25 themselves. We applied cluster analysis to identify contrasting attitudinal profiles, and logistic regressions with a model averaging method to investigate and rank the factors associated with these profiles. RESULTS A third of the respondents had never heard of HPV. However, most of the respondents who had heard of it agreed that it is a severe (93.8%) and frequent (65.1%) infection. Overall, 72.3% of them considered the HPV vaccine to be effective, but 54% had concerns about its side effects. We identified four contrasting profiles based on their perceptions of this vaccine: informed supporters, objectors, uninformed supporters, and those who were uncertain. In multivariate analysis, these attitudinal clusters were the strongest predictors of HPV vaccine uptake, followed by attitudes toward vaccination in general. CONCLUSIONS Tailored information campaigns and programs should address the specific and contrasted concerns about HPV vaccination of both young women and of their parents.
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Affiliation(s)
- Fatima Gauna
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.
- IHU-Méditerranée Infection, Marseille, France.
| | - Pierre Verger
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - Lisa Fressard
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - Marie Jardin
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Jeremy K Ward
- CERMES3 (INSERM, CNRS, EHESS, Université de Paris), Villejuif, France
| | - Patrick Peretti-Watel
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
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Garrison A, Karlsson L, Fressard L, Fasce A, Rodrigues F, Schmid P, Taubert F, Holford D, Lewandowsky S, Nynäs P, Anderson EC, Gagneur A, Dubé E, Soveri A, Verger P. International adaptation and validation of the Pro-VC-Be: measuring the psychosocial determinants of vaccine confidence in healthcare professionals in European countries. Expert Rev Vaccines 2023; 22:726-737. [PMID: 37507356 DOI: 10.1080/14760584.2023.2242479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 06/29/2023] [Accepted: 07/26/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Healthcare professionals (HCPs) play an important role in vaccination; those with low confidence in vaccines are less likely to recommend them to their patients and to be vaccinated themselves. The study's purpose was to adapt and validate long- and short-form versions of the International Professionals' Vaccine Confidence and Behaviors (I-Pro-VC-Be) questionnaire to measure psychosocial determinants of HCPs' vaccine confidence and their associations with vaccination behaviors in European countries. RESEARCH DESIGN AND METHODS After the original French-language Pro-VC-Be was culturally adapted and translated, HCPs involved in vaccination (mainly GPs and pediatricians) across Germany, Finland, France, and Portugal completed a cross-sectional online survey in 2022. A 10-factor multigroup confirmatory factor analysis (MG-CFA) of the long-form (10 factors comprising 34 items) tested for measurement invariance across countries. Modified multiple Poisson regressions tested the criterion validity of both versions. RESULTS 2,748 HCPs participated. The 10-factor structure fit was acceptable to good everywhere. The final MG-CFA model confirmed strong factorial invariance and showed very good fit. The long- and short-form I-Pro-VC-Be had good criterion validity with vaccination behaviors. CONCLUSION This study validates the I-Pro-VC-Be among HCPs in four European countries; including long- and short-form tools for use in research and public health.
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Affiliation(s)
- Amanda Garrison
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Lisa Fressard
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Philipp Schmid
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Frederike Taubert
- Institute for Planetary Health Behaviour, University of Erfurt, Erfurt, Germany
- Health Communication, Department of Implementation Research, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Dawn Holford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK
- Department of Psychology, University of Potsdam, Potsdam, Germany
- School of Psychological Science, University of Western Australia, Crawley, WA, Australia
| | - Peter Nynäs
- Faculty of Arts, Psychology and Theology, Abo Akademi University, Turku, Finland
| | | | - Arnaud Gagneur
- Department of Pediatrics, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Eve Dubé
- Département d'anthropologie, Faculté des Sciences Sociales, Université Laval, Laval, Canada
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Pierre Verger
- Faculté des Sciences Médicales Et Paramédicales, Southeastern Health Regional Observatory (Observatoire Régional de la Santé, ORS) PACA, Marseille, France
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Karafillakis E, Peretti-Watel P, Verger P, Chantler T, Larson HJ. " We don't have the same bodies; we don't react the same way": mothers and adolescent girls' perceptions of the risks and benefits of HPV vaccination in France. Hum Vaccin Immunother 2022; 18:2036555. [PMID: 35240936 PMCID: PMC9009901 DOI: 10.1080/21645515.2022.2036555] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Human Papillomavirus (HPV) vaccination is one of the most publicly mistrusted vaccines in Europe, with countries such as France struggling with low vaccine uptake due to parental questioning of vaccine risks and benefits. However, limited evidence exists on adolescent girls' perceptions of the risks and benefits of HPV vaccination. The aim of this qualitative study was to provide an in-depth exploration and comparison of French mothers (n = 21) and adolescent girls' (n = 36) perceptions of the risks and benefits of HPV vaccination. A thematic analysis showed that adolescent girls and mothers perceived the risks and benefits of HPV vaccination differently, with girls reporting positive and beneficial views and emotions toward vaccination and mothers expressing concerns about possible risks. Adolescent girls also reported that both perceptions and actual risks and benefits may vary from one individual to another. Vaccine safety was also understood differently, with mothers reporting a widespread view that vaccines are unsafe and focusing on controversial side effects and girls discussing short-term consequences of vaccination (e.g. pain, fever) and administration and storage issues. Strategies to improve uptake of HPV vaccination should consider and address both the mothers' and daughters' perceptions and understandings of HPV vaccination.
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Affiliation(s)
- E Karafillakis
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - P Peretti-Watel
- UMR Vitrome, Aix-Marseille Université, IHU Méditerrannée, IRD, Marseille, France.,Southeastern Health Regional Observatory (ORS Paca),Aix-Marseille Université, Marseille, France
| | - P Verger
- Southeastern Health Regional Observatory (ORS Paca),Aix-Marseille Université, Marseille, France
| | - T Chantler
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - H J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.,Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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Carrier H, Zaytseva A, Bocquier A, Villani P, Fortin M, Verger P. General practitioners' attitude towards cooperation with other health professionals in managing patients with multimorbidity and polypharmacy: A cross-sectional study. Eur J Gen Pract 2022; 28:109-117. [PMID: 35593116 PMCID: PMC9132456 DOI: 10.1080/13814788.2022.2044781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Cooperation between general practitioners (GPs) and other healthcare professionals appears to help reduce the risk of polypharmacy-related adverse events in patients with multimorbidity. Objectives To investigate GPs profiles according to their opinions and attitudes about interprofessional cooperation and to study the association between these profiles and GPs’ characteristics. Methods Between May and July 2016, we conducted a cross-sectional survey of a panel of French GPs about their management of patients with multimorbidity and polypharmacy, focussing on their opinions on the roles of healthcare professionals and interprofessional cooperation. We used agglomerative hierarchical cluster analysis to identify GPs profiles, then multivariable logistic regression models to study their associations with the characteristics of these doctors. Results 1183 GPs responded to the questionnaire. We identified four profiles of GPs according to their declared attitudes towards cooperation: GPs in the ‘very favourable’ profile (14%) were willing to cooperate with various health professionals, including the delegation of some prescribing tasks to pharmacists; GPs in the ‘moderately favourable’ profile (47%) had favourable views on the roles of health professionals, with the exception for this specific delegation of the task; GPs from the ‘selectively favourable’ profile (27%) tended to work only with doctors; GPs from the ‘non-cooperative’ profile (12%) did not seem to be interested in cooperation. Some profiles were associated with GPs’ ages or participation in continuing medical education. Conclusion Our study highlights disparities between GPs regarding cooperation with other professionals caring for their patients and suggests ways to improve cooperation.
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Affiliation(s)
- Hélène Carrier
- Department of General Practice, Aix Marseille University, Marseille, France.,ORS Paca, Regional Health Observatory, Provence- Alpes-Côte d'Azur, Marseille, France
| | - Anna Zaytseva
- ORS Paca, Regional Health Observatory, Provence- Alpes-Côte d'Azur, Marseille, France.,Aix Marseille University, CNRS (French National Centre for Scientific Research), EHESS (School of Advanced Studies in the Social Sciences), Centrale Marseille, AMSE (Aix-Marseille School of Economics), France
| | - Aurélie Bocquier
- ORS Paca, Regional Health Observatory, Provence- Alpes-Côte d'Azur, Marseille, France
| | - Patrick Villani
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique des Hôpitaux de Marseille (AP-HM), Marseille, France.,Anthropology Bio-Cultural, Law and Ethics (ADES), French Blood Agency (EFS), National Center for Scientific Research (CNRS), Aix Marseille University, Marseille, France
| | - Martin Fortin
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Québec, Canada.,Centre Universitaire de Santé et de Services Sociaux du Saguenay-Lac St-Jean, Chicoutimi, Quebec, Canada
| | - Pierre Verger
- ORS Paca, Regional Health Observatory, Provence- Alpes-Côte d'Azur, Marseille, France
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Mitilian E, Gosselin V, Casanova L, Fressard L, Berthiaume P, Verger P, Gagneur A. Assessment of training of general practice interns in motivational interviews about vaccination. Hum Vaccin Immunother 2022; 18:2114253. [PMID: 36494997 PMCID: PMC9746523 DOI: 10.1080/21645515.2022.2114253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The effectiveness of motivational interviewing (MI) for reducing vaccine hesitancy (VH) has been demonstrated in Quebec. We conducted a study to evaluate the acquisition of MI skills after MI training via videoconferencing for interns training as general practitioners (GPs) in southeastern France. A vaccination-specific MI training workshop was offered to interns in 2021, consisting of two separate Zoom videoconference sessions. Participants completed the Motivational Interviewing Skills in Immunization questionnaire before and after the training to measure skills acquisition. We used pairwise exact Wilcoxon-Pratt signed rank tests for the analysis. Among 45 GP interns enrolled in the first MI session, 34 (75.6%) attended both sessions and completed the questionnaire at 3 different time points. After the first session, MI knowledge scores improved significantly (+21.1 ± 21.6; P < .0001), as did application of MI skills (+36.8 ± 36.7; P < .0001), and MI practice confidence (+21.2 ± 11.1; P < .0001). The second MI session maintained the skills developed after the first session without further improvement. Participant satisfaction was high. This is the first study in France assessing the impact of a vaccination-specific MI training for GP interns. It shows a substantial improvement in knowledge, application of MI skills, and self-confidence in the practice of MI. GP interns were highly satisfied with the training despite the videoconference format. These promising results will allow the integration of MI training in GP medical curricula in order to prepare future GPs for communication in the field of vaccination.
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Affiliation(s)
- Eva Mitilian
- Aix Marseille Univ, DUMG, département universitaire de médecine générale, Marseille, France,ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France,CONTACT Eva Mitilian Aix Marseille Univ, DUMG, département universitaire de médecine générale, 40, rue Saint-Bruno, Marseille13004
| | - Virginie Gosselin
- Centre de Recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Ludovic Casanova
- Aix Marseille Univ, DUMG, département universitaire de médecine générale, Marseille, France,ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France
| | - Lisa Fressard
- ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France
| | | | - Pierre Verger
- ORS PACA. Southeastern Health Regional Observatory, Faculty of Medicine, Marseille, France
| | - Arnaud Gagneur
- Centre de Recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada,Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Lutaud R, Verger P, Peretti-Watel P, Eldin C. When the patient is making the (wrong?) diagnosis: a biographical approach to patients consulting for presumed Lyme disease. Fam Pract 2022:cmac116. [PMID: 36267023 PMCID: PMC9619758 DOI: 10.1093/fampra/cmac116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Media coverage of Lyme disease (LD) has led to an increase in consultations for presumed LD in Europe. However, LD is confirmed in only 10%-20% of patients, with a significant number remaining in a diagnostic dead-end. OBJECTIVES To reach a deeper understanding of how patients themselves contribute to the diagnostic process. To describe the genesis of the LD hypothesis in care pathways. METHODS In 2019, 30 patients from a prospective cohort consulting in the infectious diseases department at University Hospital in Marseille for presumed LD were recruited for semistructured interviews. The inclusion criteria were: suffering from subjective symptoms for 6 months, no clinical or paraclinical argument suggesting current LD. The patients' medical trajectories were collected using a biographical approach. RESULTS The diagnosis of LD was primarily triggered by identification with personal testimonies found on the Internet. Most of patients were leading their own diagnostic investigation. The majority of participants were convinced they had LD despite the lack of medical evidence and the scepticism of their referring GP. CONCLUSION GPs should first systematically explore patients' aetiologic representations in order to improve adherence to the diagnosis especially in the management of medically unexplained symptoms. Long COVID-19 syndrome challenge offers an opportunity to promote active patient involvement in diagnosis.
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Affiliation(s)
- Romain Lutaud
- Department of General Practice, Aix Marseille University, Marseille, France
- UMR UMR 7268 ADES, EFS, CNRS, Aix-Marseille University, Marseille, France
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | - Pierre Verger
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France
| | | | - Carole Eldin
- UMR UVE, Aix Marseille University, IRD, Inserm, Marseille, France
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Vinet A, Bocquier A, Dubois C, Verger P, Darmon N. O2-1 Improving diet and physical activity in older adults living at home: protocol for the ALAPAGE cluster randomized controlled trial. Eur J Public Health 2022. [PMCID: PMC9421833 DOI: 10.1093/eurpub/ckac094.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Adequate nutrition and regular physical activity (PA) are key elements in healthy aging. In France, behavioural interventions promoting healthy eating and PA in older adults consist mainly in collective workshops organised by pension and health insurance funds. After analyzing pre-existing workshops, we designed the co-constructed project ALAPAGE to improve these workshops and assess their impact on diet and PA. Methods ALAPAGE is a cluster randomized controlled trial; 60 collective workshops in southeastern France will be randomized in a 2:1 (intervention/control) ratio. We will recruit 900 autonomous older adults (? 60 years) living at home and will make specific efforts to recruit socially isolated and/or economically vulnerable people. In the intervention group, collective workshop period will include 7 sessions (1 session/week): 1 introductory, 4 diet and 2 PA (to teach principles of functional dual-task exercise focused on strength, flexibility and physical functioning). During the following 3-months, participants will be recommended to perform exercises as often as possible and will participate in post-workshop activities. The control group will first participate to other types of workshops and then to a diet and PA workshop (waiting-list design). Results The dietary practices (using experimental economics), physical activity (battery of field test and habitual PA), quality of life, and cost-effectiveness will be assessed at the first and last session, and 3 months later. Conclusion Results will guide decision-makers to organize actions and their dissemination. Transferability to other regions will be facilitated by the fact that key stakeholders involved in ALAPAGE belong to structured national networks.
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Affiliation(s)
- Agnès Vinet
- LaPEC Laboratoire de Pharm-Ecologie Cardiovasculaire, University of Avignon , Avignon, France
| | - Aurélie Bocquier
- ORS PACA, Marseille, Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille , Marseille, France
| | | | - Pierre Verger
- ORS PACA, Marseille, Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille , Marseille, France
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Khouri C, Larabi A, Verger P, Gauna F, Cracowski JL, Ward J. Impact of Vaccine Hesitancy on Onset, Severity and Type of Self-reported Adverse Events: A French Cross-Sectional Survey. Drug Saf 2022; 45:1049-1056. [PMID: 35972651 PMCID: PMC9379877 DOI: 10.1007/s40264-022-01220-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 11/30/2022]
Abstract
Introduction Little is known about the impact of mandatory vaccination on people who are reluctant to be vaccinated, despite the potential importance in terms of public health policy. Objective We aimed to explore the relationship between vaccine hesitancy and onset, severity and characteristics of self-reported adverse events. Methods We used a cross-sectional online survey conducted in 2021 among a representative sample of the French population aged 18 years and older (n = 1593). All reported adverse events were analyzed and categorized by trained experts in drug safety and pharmacovigilance. Multivariate binomial regressions on the onset of self-reported adverse events, vaccine hesitancy categories and predefined responders’ characteristics were performed. Results Overall, 590 (37.0%) participants reported at least one adverse event, with 121 (20.5%) considered it to be severe. Proportions of reported adverse events, ranging from 18% (in non-reluctant responders) to 65% (in very reluctant responders), and their severity, ranging from 5% (non-reluctant responders) to 41% (very reluctant responders), depended highly on attitudes toward vaccination. The adverse events profile remained similar between groups. In the multivariate regression model, beyond attitude toward vaccination, younger age and female gender were significantly associated with higher reporting of vaccine adverse events. Conclusions Our results suggest that vaccine hesitancy could be a major driver of patient-reported vaccine-related adverse events and their perceived severity. In this context, vaccinators must pay special attention to reluctant patients and inform them on the possible nocebo nature of these adverse events so as to prevent them. Supplementary Information The online version contains supplementary material available at 10.1007/s40264-022-01220-0.
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Affiliation(s)
- Charles Khouri
- Pharmacovigilance Unit, Grenoble Alpes University Hospital, Grenoble, France.
- HP2 Laboratory, Inserm U1300, Grenoble Alpes University, Grenoble, France.
| | - Ayoub Larabi
- Pharmacovigilance Unit, Grenoble Alpes University Hospital, Grenoble, France
| | - Pierre Verger
- VITROME (Aix Marseille Université, IRD, AP-HM, SSA), Marseille, France
- Observatoire régional de la santé PACA (ORS Paca), Aix-Marseille Université, Marseille, France
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France
| | - Fatima Gauna
- Observatoire régional de la santé PACA (ORS Paca), Aix-Marseille Université, Marseille, France
| | - Jean-Luc Cracowski
- Pharmacovigilance Unit, Grenoble Alpes University Hospital, Grenoble, France
- HP2 Laboratory, Inserm U1300, Grenoble Alpes University, Grenoble, France
| | - Jeremy Ward
- VITROME (Aix Marseille Université, IRD, AP-HM, SSA), Marseille, France
- CERMES3 (INSERM, CNRS, EHESS, Université de Paris), Villejuif, France
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20
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Garrison A, Fressard L, Karlsson L, Soveri A, Fasce A, Lewandowsky S, Schmid P, Gagneur A, Dubé E, Verger P. Measuring psychosocial determinants of vaccination behavior in healthcare professionals: validation of the Pro-VC-Be short-form questionnaire. Expert Rev Vaccines 2022; 21:1505-1514. [PMID: 35938710 DOI: 10.1080/14760584.2022.2108800] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Vaccine confidence among health care professionals (HCPs) is a key determinant of vaccination behaviors. We validate a short-form version of the 31-item Pro-VC-Be (Health Professionals Vaccine Confidence and Behaviors) questionnaire that measures HCPs' confidence in and commitment to vaccination. RESEARCH DESIGN AND METHODS A cross-sectional survey among 2,696 HCPs established a long-form tool to measure 10 dimensions of psychosocial determinants of vaccination behaviors. Confirmatory factor analysis (CFA) models tested the construct validity of 69,984 combinations of items in a 10-item short form tool. The criterion validity of this tool was tested with four behavioral and attitudinal outcomes using weighted modified Poisson regressions. An immunization resource score was constructed from summing the responses of the dimensions that can influence HCPs' pro-vaccination behaviors: vaccine confidence, proactive efficacy, and trust in authorities. RESULTS The short-form tool showed good construct validity in CFA analyses (RMSEA = 0.035 [0.024; 0.045]; CFI = 0.956; TLI = 0.918; SRMR 0.027) and comparable criterion validity to the long-form tool. The immunization resource score showed excellent criterion validity. CONCLUSIONS The Pro-VC-Be short-form showed good construct validity and criterion validity similar to the long-form and can therefore be used to measure determinants of vaccination behaviors among HCPs.
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Affiliation(s)
- Amanda Garrison
- Faculty of Medicine, ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Lisa Fressard
- Faculty of Medicine, ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Stephan Lewandowsky
- School of Psychological Science, University of Bristol, Bristol, UK.,School of Psychological Science, University of Western Australia, Perth, Australia
| | - Philipp Schmid
- Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Arnaud Gagneur
- Department of Pediatrics, Centre de Recherche du CHUS, Sherbrooke, Quebec, Canada.,Département de Pédiatrie, Université de Sherbrooke-Campus de la Santé, Sherbrooke, Quebec, Canada
| | - Eve Dubé
- Department of Anthropology, Laval University, Quebec City, Quebec, Canada
| | - Pierre Verger
- Faculty of Medicine, ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
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21
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Alleaume C, Peretti-Watel P, Beck F, Leger D, Vaiva G, Verger P. Incidence of PTSD in the French population a month after the COVID-19 pandemic-related lockdown: evidence from a national longitudinal survey. BMC Public Health 2022; 22:1500. [PMID: 35932014 PMCID: PMC9356417 DOI: 10.1186/s12889-022-13880-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In view of experts' warnings about the potential negative mental health consequences of the sudden nationwide lockdowns implemented in many countries to limit the spread of the COVID-19 pandemic, we sought to study the incidence of posttraumatic stress disorder (PTSD) after traumatic events related to this unprecedented lockdown in the French general population. METHODS This longitudinal study among adults (aged =18) consisted of two surveys: the first during the last days of the lockdown and the second a month later. We estimated PTSD incidence with the PCL-5 and ran multiple Poisson regression models to identify factors associated with PTSD. RESULTS Among the 1736 participants, 30.1% reported at least one traumatic event. PTSD incidence was 17.5% (95% confidence interval CI = 15.7-19.3). It was higher in participants who reported multiple traumatic events, who had high COVID-19-related media use, who had general anxiety disorder (GAD-7) during the lockdown, and who had GAD, depression (PHQ-9), or sleep problems 1 month later. In addition, 43.1% of people with PTSD reported suicidal thoughts. CONCLUSIONS These results should help clinicians to target people who are at high risk of developing PTSD after a pandemic-related lockdown and could benefit from preventive measures. Collaboration between the media and mental health professionals could be envisioned to inform the population about care resources. Follow-up recommendations should also be disseminated to general practitioners to facilitate PTSD screening and ensure that they are aware of the appropriate management.
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Affiliation(s)
- Caroline Alleaume
- Southeastern Health Regional Observatory (ORS Paca), Faculté des Sciences Médicales et Paramédicales, 27 Bd Jean Moulin 13385, CEDEX 5, Marseille, France.
| | - Patrick Peretti-Watel
- Southeastern Health Regional Observatory (ORS Paca), Faculté des Sciences Médicales et Paramédicales, 27 Bd Jean Moulin 13385, CEDEX 5, Marseille, France.,Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - François Beck
- CESP, University Paris Sud, Faculté de médecine UVSQ, Inserm, University Paris-Saclay, Villejuif, France
| | - Damien Leger
- Université de Paris, EA 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), Paris, France.,APHP- Hôtel-Dieu, Centre du sommeil et de la Vigilance, Paris, France
| | - Guillaume Vaiva
- U1172 INSERM Lille Neurosciences & Cognitions, Centre National de Ressources & Résilience pour les psychotraumatismes (Lille - Paris), Lille, France
| | - Pierre Verger
- Southeastern Health Regional Observatory (ORS Paca), Faculté des Sciences Médicales et Paramédicales, 27 Bd Jean Moulin 13385, CEDEX 5, Marseille, France
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22
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Bocquier A, Jacquemot AF, Dubois C, Tréhard H, Cogordan C, Maradan G, Cortaredona S, Fressard L, Davin-Casalena B, Vinet A, Verger P, Darmon N, Arquier V, Briclot G, Chamla R, Cousson-Gélie F, Danthony S, Delrieu K, Dessirier J, Féart C, Fusinati C, Gazan R, Gibert M, Lamiraud V, Maillot M, Nadal D, Trotta C, Verger EO, Viriot V. Study protocol for a pragmatic cluster randomized controlled trial to improve dietary diversity and physical fitness among older people who live at home (the "ALAPAGE study"). BMC Geriatr 2022; 22:643. [PMID: 35927684 PMCID: PMC9351201 DOI: 10.1186/s12877-022-03260-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diet and physical activity are key components of healthy aging. Current interventions that promote healthy eating and physical activity among the elderly have limitations and evidence of French interventions' effectiveness is lacking. We aim to assess (i) the effectiveness of a combined diet/physical activity intervention (the "ALAPAGE" program) on older peoples' eating behaviors, physical activity and fitness levels, quality of life, and feelings of loneliness; (ii) the intervention's process and (iii) its cost effectiveness. METHODS We performed a pragmatic cluster randomized controlled trial with two parallel arms (2:1 ratio) among people ≥60 years old who live at home in southeastern France. A cluster consists of 10 people participating in a "workshop" (i.e., a collective intervention conducted at a local organization). We aim to include 45 workshops randomized into two groups: the intervention group (including 30 workshops) in the ALAPAGE program; and the waiting-list control group (including 15 workshops). Participants (expected total sample size: 450) will be recruited through both local organizations' usual practices and an innovative active recruitment strategy that targets hard-to-reach people. We developed the ALAPAGE program based on existing workshops, combining a participatory and a theory-based approach. It includes a 7-week period with weekly collective sessions supported by a dietician and/or an adapted physical activity professional, followed by a 12-week period of post-session activities without professional supervision. Primary outcomes are dietary diversity (calculated using two 24-hour diet recalls and one Food Frequency Questionnaire) and lower-limb muscle strength (assessed by the 30-second chair stand test from the Senior Fitness Test battery). Secondary outcomes include consumption frequencies of main food groups and water/hot drinks, other physical fitness measures, overall level of physical activity, quality of life, and feelings of loneliness. Outcomes are assessed before the intervention, at 6 weeks and 3 months later. The process evaluation assesses the fidelity, dose, and reach of the intervention as its causal mechanisms (quantitative and qualitative data). DISCUSSION This study aims to improve healthy aging while limiting social inequalities. We developed and evaluated the ALAPAGE program in partnership with major healthy aging organizations, providing a unique opportunity to expand its reach. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05140330 , December 1, 2021. PROTOCOL VERSION Version 3.0 (November 5, 2021).
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Affiliation(s)
- Aurélie Bocquier
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France. .,Université de Lorraine, APEMAC, F-54000, Nancy, France.
| | - Anne-Fleur Jacquemot
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Bordeaux Population Health Research Center, University of Bordeaux, Inserm, UMR 1219, F-33000, Bordeaux, France
| | | | - Hélène Tréhard
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, INSERM, SESSTIM, Aix Marseille Institute of Public Health, ISSPAM, Marseille, France
| | - Chloé Cogordan
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Gwenaëlle Maradan
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Sébastien Cortaredona
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Lisa Fressard
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | | | - Agnès Vinet
- Avignon Université, UPR EA4278, F-84000, Avignon, France
| | - Pierre Verger
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Nicole Darmon
- MoISA, Université de Montpellier, CIHEAM-IAMM, CIRAD, INRAE, Institut Agro, IRD, Montpellier, France
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23
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Jung YJ, Gagneux-Brunon A, Bonneton M, Botelho-Nevers E, Verger P, Ward JK, Launay O. Factors associated with COVID-19 vaccine uptake among French population aged 65 years and older: results from a national online survey. BMC Geriatr 2022; 22:637. [PMID: 35918635 PMCID: PMC9344255 DOI: 10.1186/s12877-022-03338-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background In France, the increase in COVID-19 vaccine uptake among older adults slowed down between May and June 2021. Using the data from a national survey, we aimed to assess COVID-19 vaccine uptake among French residents aged 65 years and older, particularly at risk of severe form of the infection, and identify factors associated with non-vaccination. Methods A cross-sectional online survey collected the immunization status/intention to get the COVID-19 vaccine, reasons for vaccination/non-vaccination and factors potentially associated with vaccine uptake between May 10 and 23, 2021 among a large sample of French residents. Characteristics of participants were compared according to immunization status. Factors potentially associated with non-vaccination were computed into a multivariate logistic regression. Results Among the 1941 survey participants, 1612 (83%) reported having received at least one dose of COVID-19 vaccine. Among the 329 unvaccinated, 197 (60%) declared having the intention to get vaccinated. Younger age (adjusted odds ratio (aOR) = 1.50; 95% confidence interval (CI), 1.05–2.14), thinking previously having COVID-19 (aOR = 4.01; 95% CI, 2.17–7.40), having suffered economic impact due to the pandemic (aOR = 2.63; 95% CI, 1.71–4.04), reporting an “unsafe” opinion about COVID-19 vaccine safety (aOR = 6.79; 95% CI, 4.50–10.26), reporting an “unsupportive” opinion about vaccination in general (aOR = 4.24; 95% CI, 2.77–6.49) were independent risk factors for non-vaccination. On the other hand, trust in COVID-19 vaccine information delivered by the doctor (aOR = 0.28; 95% CI, 0.16–0.48) and trust in the government’s actions (aOR = 0.50; 95% CI, 0.34–0.74) were independent protective factors for non-vaccination. Political affiliation also remained significantly associated with vaccine uptake. Conclusions Despite high overall COVID-19 vaccine uptake among the study participants, differences in vaccine uptake according to the level of concerns regarding COVID-19 vaccine safety, socioeconomic profile and trust in the government were observed. Our results reinforce the importance of “reaching out” vaccination strategy that specifically targets the most vulnerable fringe of older adult population. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03338-3.
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Affiliation(s)
- Yu-Jin Jung
- Université de Paris, Inserm, Centre d'Investigation Clinique (CIC) 1417, Assistance Publique - Hôpitaux de Paris, CIC Cochin-Pasteur, Hôpital Cochin, 27 Rue du Faubourg Saint-Jacques, Paris, France.
| | - Amandine Gagneux-Brunon
- Centre International de Recherche en Infectiologie, Team GIMAP, Université de Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U111, Centre National de Recherche Scientifique (CNRS), Unité mixte de recherche (UMR) 530, Lyon, France.,Inserm, CIC 1408 Vaccinologie, CHU de Saint-Etienne, Saint-Etienne, France.,Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France.,Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France
| | | | - Elisabeth Botelho-Nevers
- Centre International de Recherche en Infectiologie, Team GIMAP, Université de Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U111, Centre National de Recherche Scientifique (CNRS), Unité mixte de recherche (UMR) 530, Lyon, France.,Inserm, CIC 1408 Vaccinologie, CHU de Saint-Etienne, Saint-Etienne, France.,Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France.,Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France
| | - Pierre Verger
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France.,Observatoire Régional de la Santé (ORS) - Provence-Alpes-Côte d'Azur, Marseille, France.,VITROME (Aix-Marseille Université, Institut de Recherche pour le Développement, Assistance Publique - Hôpitaux de Marseille, Service de Santé des Armées), Marseille, France
| | - Jeremy K Ward
- VITROME (Aix-Marseille Université, Institut de Recherche pour le Développement, Assistance Publique - Hôpitaux de Marseille, Service de Santé des Armées), Marseille, France.,CERMES3 (Inserm, CNRS, Ecole des Hautes Etudes en Sciences Sociales, Université de Paris, Villejuif, France
| | - Odile Launay
- Université de Paris, Inserm, Centre d'Investigation Clinique (CIC) 1417, Assistance Publique - Hôpitaux de Paris, CIC Cochin-Pasteur, Hôpital Cochin, 27 Rue du Faubourg Saint-Jacques, Paris, France.,Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France
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24
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Gagneux-Brunon A, Ward JK, Bonneton M, Verger P, Launay O, Botelho-Nevers E. Intention to participate in COVID-19 vaccine clinical trials in May 2021: a cross-sectional survey in the general French population. Hum Vaccin Immunother 2022; 18:2072630. [PMID: 35561252 PMCID: PMC9481082 DOI: 10.1080/21645515.2022.2072630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In May 2021, while the immunization campaign was in progress, the emergence of new SARS-CoV-2 variants led us to assess attitudes toward participation in a COVID-19 vaccine clinical trial (VCT) in France. Between the 10th and the 23rd of May 2021, we conducted a cross-sectional online survey among a representative sample of the French population aged 18 and over and a specific sample of the French population over 65. Among the 3,056 respondents, 28.0% (856) would consider participation in a COVID-19 VCT. Factors independently negatively associated with willingness to participate in a COVID-19 VCT were female gender with an adjusted odd ratio (aOR) 0.42 and 95% confidence interval (95% CI) 0.35–0.51, and mistrust in health actors (in their own physician and pharmacists, health ministry, government, scientists in medias, medias and pharmaceutical companies) with aOR 0.86 (95% CI 0.84–0.88) by one-point increase in mistrust in health actors score. Factors positively associated with willingness to participate in a COVID-19 VCT were COVID-19 vaccination or intention to get vaccinated with aOR 4.89 (95% CI 3.15–7.61), being a healthcare worker with aOR 2.051 (95% CI 1.51–2.80), being at risk for severe COVID-19 with aOR 1.39 (95% CI 1.14–1.69) and altruism as the main reason for getting vaccination with aOR 1.56 (95% CI 1.29–1.88). In May 2021, despite COVID 19 vaccine availability, 28% of the French population would agree to participate in a COVID-19 VCT. Mistrust in health actors contributes to a reduction in the intention to participate. Attitudes toward COVID-19 vaccination predict attitudes toward participation in a COVID-19 VCT.
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Affiliation(s)
- Amandine Gagneux-Brunon
- Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, Saint-Etienne, France.,CIC INSERM 1408 Vaccinologie, CHU de Saint-Etienne, Saint-Etienne, France.,Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France.,Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France
| | - Jeremy K Ward
- Laboratory VITROME (Aix Marseille Université, IRD, AP-HM,SSA), Marseille, France.,Laboratory CERMES3 (INSERM, CNRS, EHESS, Université deParis), Villejuif, France
| | - Marion Bonneton
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France.,CIC 1417, INSERM, Assistance Publique - Hôpitaux de Paris, Université de Paris, Hôpital Cochin, Paris, France
| | - Pierre Verger
- Laboratory VITROME (Aix Marseille Université, IRD, AP-HM,SSA), Marseille, France.,Observatoire régional de la santé Paca, Marseille, France
| | - Odile Launay
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France.,CIC 1417, INSERM, Assistance Publique - Hôpitaux de Paris, Université de Paris, Hôpital Cochin, Paris, France
| | - Elisabeth Botelho-Nevers
- Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, Saint-Etienne, France.,CIC INSERM 1408 Vaccinologie, CHU de Saint-Etienne, Saint-Etienne, France.,Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France
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25
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Zaytseva A, Verger P, Ventelou B. United, can we be stronger? Did French general practitioners in multi-professional groups provide more chronic care follow-up during lockdown? BMC Health Serv Res 2022; 22:519. [PMID: 35440039 PMCID: PMC9016683 DOI: 10.1186/s12913-022-07937-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Given the importance of the continuous follow-up of chronic patients, we evaluated the performance of French private practice general practitioners (GPs) practicing in multi-professional group practices (MGP) regarding chronic care management during the first Covid-19 lockdown in Spring 2020 compared to GPs not in MGP. We consider two outcomes: continuity of care provision for chronic patients and proactivity in contacting these patients. Methods The cross-sectional web questionnaire of 1191 GPs took place in April 2020. We exploit self-reported data on: 1) the frequency of consultations for chronic patients during lockdown compared to their “typical” week before the pandemic, along with 2) GPs’ proactive behaviour when contacting their chronic patients. We use probit and bivariate probit models (adjusted for endogeneity of choice of engagement in MGP) to test whether GPs in MGP had significantly different responses to the Covid-19 crisis compared to those practicing outside MGP. Results Out of 1191 participants (response rate: 43.1%), around 40% of GPs were female and 34% were younger than 50 years old. Regression results indicate that GPs in MGP were less likely to experience a drop in consultations related to complications of chronic diseases (− 45.3%). They were also more proactive (+ 13.4%) in contacting their chronic patients compared to their peers practicing outside MGP. Conclusion We demonstrate that the MGP organisational formula was beneficial to the follow-up of patients with chronic conditions during the lockdown; therefore, it appears beneficial to expand integrated practices, since they perform better when facing a major shock. Further research is needed to confirm the efficiency of these integrated practices outside the particular pandemic setup. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07937-z.
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Affiliation(s)
- Anna Zaytseva
- Aix-Marseille University, CNRS, EHESS, Centrale Marseille, AMSE, 5-9 Boulevard Maurice Bourdet, CS 50498, 13205, Marseille Cedex 1, France. .,Southeastern Regional Health Observatory, ORS Paca, Provence-Alpes-Côte d'Azur, Marseille, France, 27 Boulevard Jean Moulin, 13385, Marseille Cedex 5, France.
| | - Pierre Verger
- Southeastern Regional Health Observatory, ORS Paca, Provence-Alpes-Côte d'Azur, Marseille, France, 27 Boulevard Jean Moulin, 13385, Marseille Cedex 5, France.,Aix-Marseille University, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, 19-21 Boulevard Jean Moulin, 13005, Marseille, France
| | - Bruno Ventelou
- Aix-Marseille University, CNRS, EHESS, Centrale Marseille, AMSE, 5-9 Boulevard Maurice Bourdet, CS 50498, 13205, Marseille Cedex 1, France
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26
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Verger P, Botelho-Nevers E, Garrison A, Gagnon D, Gagneur A, Gagneux-Brunon A, Dubé E. Vaccine hesitancy in health-care providers in Western countries: a narrative review. Expert Rev Vaccines 2022; 21:909-927. [PMID: 35315308 DOI: 10.1080/14760584.2022.2056026] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Vaccine hesitancy (VH) is a leading cause of suboptimal vaccine uptake rates worldwide. The interaction between patients and health-care providers (HCPs) is the keystone in addressing VH. However, significant proportions of HCPs, including those who administer vaccines, are personally and professionally vaccine-hesitant. AREAS COVERED This narrative review sought to characterize the nature, extent, correlates, and consequences of VH among HCPs. We included 39 quantitative and qualitative studies conducted in Western countries, published since 2015, that assessed VH among HCPs in general, for several vaccines. Studies were reviewed using the WHO 3Cs model - (lack of) confidence, complacency, and (lack of) convenience. EXPERT OPINION Despite the lack of validated tools and substantial heterogeneity in the methods used to measure VH among HCPs, this review confirms its presence in this population, at frequencies that vary by country, profession type, setting, and level of medical education. Lack of knowledge and mistrust in health authorities/pharmaceutical industry/experts were among its principal drivers. Improving the content about vaccination in HCPs' training programs, facilitating access to reliable information for use during consultations, and developing and validating instruments to measure HCPs' VH and its determinants are key to addressing VH among HCPs.
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Affiliation(s)
- Pierre Verger
- ORS Paca, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Elisabeth Botelho-Nevers
- Department of Infectious Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France.,CIRI - Centre International de Recherche en Infectiologie, Lyon, France.,Univ Lyon, Jean Monnet University, Saint-Etienne, France.,Chair PreVacCi, Presage Institut, Jean Monnet University, Saint-Etienne, France
| | - Amanda Garrison
- ORS Paca, Southeastern Health Regional Observatory, Marseille, France.,Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Dominique Gagnon
- Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Quebec, Canada
| | - Arnaud Gagneur
- Department of Pediatrics, Centre de Recherche du CHUS, Quebec, Canada.,Faculté de médecine et des sciences de la santé, Département de pédiatrie, Université de Sherbrooke-Campus de la Santé, Quebec, Canada
| | - Amandine Gagneux-Brunon
- Department of Infectious Diseases, University Hospital of Saint-Etienne, Saint-Etienne, France.,CIRI - Centre International de Recherche en Infectiologie, Lyon, France.,Univ Lyon, Jean Monnet University, Saint-Etienne, France.,Chair PreVacCi, Presage Institut, Jean Monnet University, Saint-Etienne, France.,CIC INSERM Vaccinology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Eve Dubé
- Deptartment of Anthropology, Laval University, Quebec, Canada
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Verger P, Fressard L, Soveri A, Dauby N, Fasce A, Karlsson L, Lewandoswky S, Schmid P, Dube E, Gagneur A. An instrument to measure psychosocial determinants of health care professionals' vaccination behavior: Validation of the Pro-VC-Be questionnaire. Expert Rev Vaccines 2022; 21:693-709. [PMID: 35238274 DOI: 10.1080/14760584.2022.2046467] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The lack of validated instruments assessing vaccine hesitancy/confidence among health care professionals (HCPs) for themselves, and their patients led us to develop and validate the Pro-VC-Be instrument to measure vaccine confidence and other psychosocial determinants of HCPs' vaccination behavior among diverse HCPs in different countries. METHODS Cross-sectional survey in October-November 2020 among 1,249 GPs in France, 432 GPs in French-speaking parts of Belgium, and 1,055 nurses in Quebec (Canada), all participating in general population immunization. Exploratory and confirmatory factor analyses evaluated the instrument's construct validity. We used HCPs' self-reported vaccine recommendations to patients, general immunization activity, self-vaccination, and future COVID-19 vaccine acceptance to test criterion validity. RESULTS The final results indicated a 6-factor structure with good fit: vaccine confidence (combining complacency, perceived vaccine risks, perceived benefit-risk balance, perceived collective responsibility), trust in authorities, perceived constraints, proactive efficacy (combining commitment to vaccination and self-efficacy), reluctant trust, and openness to patients. The instrument showed good convergent and criterion validity and adequate discriminant validity. CONCLUSIONS This study found that the Pro-VC-Be is a valid instrument for measuring psychosocial determinants of HCPs' vaccination behaviors in different settings. Its validation is currently underway in Europe among various HCPs in different languages.
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Affiliation(s)
- Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Lisa Fressard
- ORS PACA, Southeastern Health Regional Observatory, Faculty of Medicine, Aix-Marseille University, Marseille, France
| | - Anna Soveri
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Nicolas Dauby
- Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Centre for Environmental Health and Occupational Health, School of Public health, Université Libre de Bruxelles (ULB), Brussel, Belgium.,Institute for Medical Immunology, Université Libre de Bruxelles (ULB), Brussel, Belgium
| | - Angelo Fasce
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Linda Karlsson
- Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Stephan Lewandoswky
- School of Psychological Science, University of Bristol, Bristol, United Kingdom.,School of Psychological Science, University of Western Australia, Perth, Australia
| | - Philipp Schmid
- Media and Communication Science, University of Erfurt, Erfurt, Germany
| | - Eve Dube
- Département d'Anthropologie, Faculté des Sciences Sociales, Université Laval, Quebec, Canada.,Institut National de la Santé Publique du Québec, Quebec, Canada.,Centre de Recherche du CHU de Québec, Université Laval, Quebec, Canada
| | - Arnaud Gagneur
- Department of Pediatrics, Centre de Recherche du CHUS, Sherbrooke, Canada.,Université de Sherbrooke-Campus de la Santé, Sherbrooke,Canada
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Ward JK, Gauna F, Gagneux-Brunon A, Botelho-Nevers E, Cracowski JL, Khouri C, Launay O, Verger P, Peretti-Watel P. The French health pass holds lessons for mandatory COVID-19 vaccination. Nat Med 2022; 28:232-235. [PMID: 35022575 DOI: 10.1038/s41591-021-01661-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jeremy K Ward
- CERMES3 (INSERM, CNRS, EHESS, Université de Paris), Villejuif, France. .,VITROME (Aix Marseille Université, IRD, AP-HM, SSA), Marseille, France.
| | - Fatima Gauna
- Observatoire régional de la santé PACA (ORS Paca), Aix-Marseille Université, Marseille, France
| | - Amandine Gagneux-Brunon
- Centre International de Recherche en Infectiologie, Team GIMAP, Université de Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U111, Centre National de Recherche Scientifique (CNRS), Unité mixte de recherche (UMR) 530, Lyon, France.,Inserm, CIC 1408 Vaccinologie, CHU de Saint-Etienne, Saint-Etienne, France.,Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France.,Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France
| | - Elisabeth Botelho-Nevers
- Centre International de Recherche en Infectiologie, Team GIMAP, Université de Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U111, Centre National de Recherche Scientifique (CNRS), Unité mixte de recherche (UMR) 530, Lyon, France.,Inserm, CIC 1408 Vaccinologie, CHU de Saint-Etienne, Saint-Etienne, France.,Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France.,Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France
| | - Jean-Luc Cracowski
- Pharmacovigilance Unit, Grenoble Alpes University Hospital, Grenoble, France
| | - Charles Khouri
- Pharmacovigilance Unit, Grenoble Alpes University Hospital, Grenoble, France.,Univ. Grenoble Alpes, HP2 Laboratory, Inserm U1300,, Grenoble, France
| | - Odile Launay
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France.,Université de Paris, Inserm, Centre d'Investigation Clinique (CIC) 1417, Assistance Publique - Hôpitaux de Paris, CIC Cochin-Pasteur, Hôpital Cochin, Paris, France
| | - Pierre Verger
- Observatoire régional de la santé PACA (ORS Paca), Aix-Marseille Université, Marseille, France.,Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France
| | - Patrick Peretti-Watel
- VITROME (Aix Marseille Université, IRD, AP-HM, SSA), Marseille, France.,Observatoire régional de la santé PACA (ORS Paca), Aix-Marseille Université, Marseille, France
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Karafillakis E, Peretti-Watel P, Verger P, Chantler T, Larson H. ‘I trust them because my mum trusts them’: Exploring the role of trust in HPV vaccination decision-making among adolescent girls and their mothers in France. Vaccine 2022; 40:1090-1097. [DOI: 10.1016/j.vaccine.2022.01.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 11/28/2022]
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Verger P, Peretti-Watel P, Gagneux-Brunon A, Botelho-Nevers E, Sanchez A, Gauna F, Fressard L, Bonneton M, Launay O, Ward JK. Acceptance of childhood and adolescent vaccination against COVID-19 in France: a national cross-sectional study in May 2021. Hum Vaccin Immunother 2021; 17:5082-5088. [PMID: 34905467 PMCID: PMC8904022 DOI: 10.1080/21645515.2021.2004838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The French health authorities extended vaccination against COVID-19 to adolescents in June 2021, during the epidemic resurgence linked to the delta variant and because of insufficient vaccination coverage to ensure collective protection. In May 2021, we conducted a national online cross-sectional survey of 2533 adults in France to study their attitudes toward COVID-19 vaccines and their acceptance of child/adolescent vaccination according to targeted age groups (<6 years; 6-11; 12-17) and its determinants. We applied a multi-model averaged logistic regression for each of these age groups to study the determinants of favorability to vaccination. Among the respondents, 62.7% (1597) accepted COVID-19 vaccination for adolescents, 48.3% (1223) for children aged 6-11 years, and only 31% (783) for children under 6 years. Acceptance increased with fear of contracting COVID-19 and trust in institutions and decreased as the COVID-19 vaccine risk perception score increased. People favorable to vaccination in general and those sensitive to social pressure were also more often favorable to vaccinating children/adolescents than those who were not. Drivers of acceptance were ranked differently for the different age groups. Understanding these differences is essential to anticipating obstacles to vaccination of these age groups and designing appropriate information and motivational strategies to support it.
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Affiliation(s)
- Pierre Verger
- Southeastern Health Regional Observatory (ORS PACA), Marseille, France,Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France,CONTACT Pierre Verger Observatoire Régional de la Santé Paca, Faculté De Médecine, 27, Bd Jean Moulin, 13385Marseille, Cedex 5, France
| | - Patrick Peretti-Watel
- Southeastern Health Regional Observatory (ORS PACA), Marseille, France,VITROME (Aix Marseille Université, IRD, AP-HM, SSA), Marseille, France
| | - Amandine Gagneux-Brunon
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France,Centre International De Recherche En Infectiologie, Team Gimap, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, Lyon, France,CIC Inserm 1408 Vaccinologie, Chu De Saint-Etienne, France,Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France
| | - Elisabeth Botelho-Nevers
- Centre International De Recherche En Infectiologie, Team Gimap, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, Lyon, France,CIC Inserm 1408 Vaccinologie, Chu De Saint-Etienne, France,Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France
| | - Alvaro Sanchez
- Assistance Publique – Hôpitaux De Paris, Hôpital Cochin, Paris, France
| | - Fatima Gauna
- Southeastern Health Regional Observatory (ORS PACA), Marseille, France
| | - Lisa Fressard
- Southeastern Health Regional Observatory (ORS PACA), Marseille, France
| | - Marion Bonneton
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France,Université De Paris, Inserm CIC 1417, Assistance Publique – Hôpitaux De Paris, Hôpital Cochin, Paris, France
| | - Odile Launay
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, Paris, France,Université De Paris, Inserm CIC 1417, Assistance Publique – Hôpitaux De Paris, Hôpital Cochin, Paris, France
| | - Jeremy K. Ward
- VITROME (Aix Marseille Université, IRD, AP-HM, SSA), Marseille, France,CERMES3 (Inserm, CNRS, Ehess, Université De Paris), Villejuif, France
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31
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Gagneux-Brunon A, Botelho-Nevers E, Bonneton M, Peretti-Watel P, Verger P, Launay O, Ward JK. Public opinion on a mandatory COVID-19 vaccination policy in France: a cross-sectional survey. Clin Microbiol Infect 2021; 28:433-439. [PMID: 34774756 PMCID: PMC8912915 DOI: 10.1016/j.cmi.2021.10.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/30/2022]
Abstract
Objectives Reaching the last pockets of unvaccinated people is challenging, and has led to the consideration of mandatory vaccination for coronavirus disease 2019 (COVID-19). Our aim was to assess attitudes toward mandatory COVID-19 vaccination in France before the announcement of—and factors associated with opposition to—this type of policy. Methods Between the 10th and 23rd May 2021, we conducted a cross-sectional online survey among a representative sample of the French population aged 18 and over, and a specific sample of the French senior population aged over 65. Results Among 3056 respondents, 1314 (43.0%) were in favour of mandatory COVID-19 vaccination, 1281 (41.9%) were opposed to such a policy, and 461 (15.1%) were undecided. Among opponents to mandatory COVID-19 vaccination for the general population, 385 (30.05%) were in favour of mandatory COVID-19 vaccination for healthcare workers (HCWs). In multivariate analysis, the age groups 18–24 and 25–34 years were significantly more opposed than the reference group (>75 years old) with respective adjusted odds ratio (aOR) and 95% confidence interval (95%CI) 4.67 (1.73–12.61) and 3.74 (1.57–8.93). Having no intention of getting COVID-19 vaccination was strongly associated with opposition to mandatory vaccination (aOR 10.67, 95%CI 6.41–17.76). In comparison with partisans of the centre, partisans of the far left and green parties were more likely to be opposed to mandatory COVID-19 vaccine, with respective aORs (95%CI) of 1.89 (1.06–3.38) and 2.08 (1.14–3.81). Conclusion Attitudes toward mandatory COVID-19 vaccination are split in the French general population, and the debate might become politicized.
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Affiliation(s)
- Amandine Gagneux-Brunon
- Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, France; CIC INSERM 1408 Vaccinologie, CHU de Saint-Etienne, France; Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France; Inserm, F-CRIN, I-REIVAC/COVIREIVAC, 75679 Paris, France.
| | - Elisabeth Botelho-Nevers
- Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, France; CIC INSERM 1408 Vaccinologie, CHU de Saint-Etienne, France; Chaire PREVACCI, Université Jean Monnet, Saint-Etienne, France
| | | | - Patrick Peretti-Watel
- Observatoire Régional de La Santé Paca, Marseille, France; VITROME (Aix Marseille Université, IRD, AP-HM, SSA), Marseille, France
| | - Pierre Verger
- Observatoire Régional de La Santé Paca, Marseille, France; VITROME (Aix Marseille Université, IRD, AP-HM, SSA), Marseille, France
| | - Odile Launay
- Inserm, F-CRIN, I-REIVAC/COVIREIVAC, 75679 Paris, France; Université de Paris, Inserm CIC 1417, Assistance Publique - Hôpitaux de Paris, Hôpital Cochin, 75679 Paris, France
| | - Jeremy K Ward
- VITROME (Aix Marseille Université, IRD, AP-HM, SSA), Marseille, France; CERMES3 (INSERM, CNRS, EHESS, Université de Paris), Villejuif, France
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Karafillakis E, Peretti-Watel P, Verger P, Chantler T, Larson HJ. The role of maturity in adolescent decision-making around HPV vaccination in France. Vaccine 2021; 39:5741-5747. [PMID: 34483023 DOI: 10.1016/j.vaccine.2021.08.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
Mothers are often responsible for vaccination decisions in the household. However, their confidence in certain vaccines such as Human Papillomavirus (HPV) vaccines is eroding in some countries. France is one of the countries with the lowest HPV vaccine uptake in Europe, with parents delaying or refusing the vaccine for their adolescent daughters due to safety- and effectiveness-related concerns. Although parental consent is required for vaccination, adolescents' involvement in HPV vaccination decision-making could improve vaccine uptake, with self-consent procedures already introduced in some countries. Adolescents' capacity to engage in decision-making is influenced by their maturity and autonomy in health. This study explored the role of maturity in decision-making around HPV vaccination in France through qualitative interviews with adolescent girls (n = 24) and their mothers (n = 21) and two focus groups with adolescent girls (n = 12). A codebook approach to thematic analysis revealed that adolescent girls' involvement in HPV decision-making is a process that evolved with maturity. As adolescents progressed towards maturity at different speeds, some expressed childlike traits such as impulsive decisions and others described more rational, reflective decision-making. Despite these differences, most adolescents in this study described a passive role in HPV vaccination decision-making, following their parents' lead. However, their expressed desire for information and involvement in discussions indicates that their lack of engagement may not only be due to a lack of maturity but also a result of mothers and doctors excluding them from getting involved. Furthermore, as health behaviours are shaped during adolescence, the influence of vaccine hesitant mothers on their daughters' own views and beliefs could be significant, together with exposure to regular controversies in the mainstream media. Individualised approaches to engage adolescents in decision-making around their own health are needed, for example through strengthening discussions and information around HPV vaccination with parents and doctors.
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Affiliation(s)
- E Karafillakis
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
| | - P Peretti-Watel
- UMR Vitrome, AMU, IHU Méditerrannée, IRD, Marseille, France; Southeastern Health Regional Observatory (ORS Paca), Marseille, France
| | - P Verger
- UMR Vitrome, AMU, IHU Méditerrannée, IRD, Marseille, France; Southeastern Health Regional Observatory (ORS Paca), Marseille, France
| | - T Chantler
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - H J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA; Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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Singier A, Carrier H, Tournier M, Pariente A, Verger P, Salvo F. General practitioners' compliance with benzodiazepine discontinuation guidelines in patients treated with long-term lorazepam: A case-vignette cross-sectional survey. Therapie 2021; 77:349-359. [PMID: 34600759 DOI: 10.1016/j.therap.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/26/2021] [Accepted: 09/03/2021] [Indexed: 11/30/2022]
Abstract
AIM To study determinants associated with GPs' compliance with benzodiazepine discontinuation guidelines through a case-vignette of a patient with multimorbidity treated with long-term lorazepam for insomnia. METHODS This cross-sectional survey was performed in a sample of French GPs. The questionnaire included items on their characteristics and questions related to the management of a case-vignette with long-term lorazepam use consulting for a prescription renewal. GPs who proposed a dedicated consultation to discuss discontinuation or progressive discontinuation were considered as "following guidelines", while they were considered as "out-of-guidelines" if they proposed immediate discontinuation or decided not to discontinue lorazepam. A backward selection process was used to select factors to be included in the final logistic regression model. The probabilities of out-of-guidelines practice and their 95% confidence interval (95% CI) were then plotted using a heatmap graph. RESULTS Of 1,177 GPs, the majority (92.2%) were aware of the necessity to discontinue lorazepam and reported practice consistent with good practice guidelines. Women GPs aged under 50 years had the lowest estimated probability of out-of-guidelines practice. Conversely, men aged over 58 years with high consideration of patient preferences and low concern about the benefit-risk ratio of lorazepam had the highest probability of out-of-guidelines practice (27.3% [18.7%; 34.7%]). CONCLUSION GPs largely reported practice compliant with benzodiazepine discontinuation guidelines, although some GPs, mainly older men who overemphasise patient preferences, were more likely to adopt out-of-guidelines practice.
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Affiliation(s)
| | - Hélène Carrier
- Aix-Marseille Univ, Department of General Practice, 13000 Marseille, France; Aix-Marseille Univ, IRD (Research Institute for Development), AP-HM (Hospitals of Marseille), SSA (Army Health Services), VITROME, 13000 Marseille, France
| | - Marie Tournier
- Univ. Bordeaux, INSERM, BPH, U1219, 33000 Bordeaux, France; Hospital Charles Perrens, 33000 Bordeaux, France
| | - Antoine Pariente
- Univ. Bordeaux, INSERM, BPH, U1219, 33000 Bordeaux, France; CHU de Bordeaux, Pôle de Santé publique, Service de pharmacologie médicale, 33000 Bordeaux, France
| | - Pierre Verger
- Aix-Marseille Univ, IRD (Research Institute for Development), AP-HM (Hospitals of Marseille), SSA (Army Health Services), VITROME, 13000 Marseille, France; ORS PACA, Regional Health Observatory, 13000 Marseille, France
| | - Francesco Salvo
- Univ. Bordeaux, INSERM, BPH, U1219, 33000 Bordeaux, France; CHU de Bordeaux, Pôle de Santé publique, Service de pharmacologie médicale, 33000 Bordeaux, France.
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Davin-Casalena B, Jardin M, Guerrera H, Mabille J, Tréhard H, Lapalus D, Ménager C, Nauleau S, Cassaro V, Verger P, Guagliardo V. The impact of the COVID-19 epidemic on primary care in South-eastern France: implementation of a real-time monitoring system based on regional health insurance system data. Rev Epidemiol Sante Publique 2021; 69:255-264. [PMID: 34454792 PMCID: PMC8818324 DOI: 10.1016/j.respe.2021.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/19/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The spring 2020 COVID-19 epidemic severely impacted France's healthcare system. The associated lockdown (17 March- 11 May 2020) and the risk of exposure to SARS-CoV-2 led patients to change their use of healthcare. This article presents the development and implementation of a real-time system to monitor i) private doctors' activity in South-eastern France, and ii) changes in prescription of drugs for people with diabetes, mental health disorders and for certain vaccines from Mars 2020 to October 2020. METHODS Data extracted from the regional healthcare insurance databases for 2019 and 2020 were used to construct indicators of healthcare use. They were calculated on a weekly basis, starting from week 2 2020 and compared for the same period between 2019 and 2020. RESULTS Private doctors' activity decreased during the spring 2020 lockdown (by 23 % for general practitioners and 46 % for specialists), followed by an almost complete return to normal after it ended until week 41. Over the same period, a huge increase in teleconsultations was observed, accounting for 30 % of private doctors' consultations at the height of the crisis. The start of the lockdown was marked by a peak in drug prescriptions, while vaccinations declined sharply (by 39 % for the measles, mumps and rubella (MMR) vaccine in children under 5 years old, and by 54 % for human papillomavirus vaccine in girls aged 10-14 years old). CONCLUSION The ongoing COVID-19 epidemic may lead to health consequences other than those directly attributable to the disease itself. Specifically, lockdowns and foregoing healthcare could be very harmful at the individual and population levels. The latter issue is a concern for French public authorities, which have implemented actions aimed at encouraging patients to immediately seek treatment. However, the COVID-19 crisis has also created opportunities, such as the roll-out of teleconsultation and tele-expertise. The indicators described here as part of the monitoring system can help public decision-makers to become more responsive and to implement tailored actions to better meet the general population's healthcare needs.
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Affiliation(s)
- B Davin-Casalena
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille.
| | - M Jardin
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - H Guerrera
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - J Mabille
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - H Tréhard
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - D Lapalus
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - C Ménager
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - S Nauleau
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - V Cassaro
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - P Verger
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - V Guagliardo
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
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Alleaume C, Verger P, Dib F, Ward JK, Launay O, Peretti-Watel P. Intention to get vaccinated against COVID-19 among the general population in France: Associated factors and gender disparities. Hum Vaccin Immunother 2021; 17:3421-3432. [PMID: 34292140 DOI: 10.1080/21645515.2021.1893069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
As the coronavirus disease 2019 (COVID-19) spreads across the world, the rapid distribution of an effective vaccine and its acceptability among the population constitute priorities for health authorities. This study aimed to document attitudes of the general population toward a future vaccine against COVID-19. We used the national COCONEL surveys conducted during the lockdown to identify factors associated with vaccine refusal, in the whole population, and separately among men and women. We investigate the role of socioeconomic and demographic factors as well as exposure to COVID-19. Among the 5,018 participants, 24.0% reported their intention to refuse the vaccine. Thinking this vaccine would not be safe, being against vaccination in general, and perceiving COVID-19 to be harmless were the three main reasons given to explain vaccine refusal. Women were more likely to refuse the vaccine, especially due to a reluctance toward vaccination in general or the perception that a COVID-19 vaccine would not be safe. Some factors associated with the intention to refuse the vaccine were the same among men and women such as a lack of prior vaccination against influenza, and concern over being infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), while others differed slightly according to gender such as age, and high prevalence of COVID-19 in their region of residence. Authorities should therefore guarantee that all the necessary precautions are taken before marketing the vaccine and communicate transparently on the process of its development, and on the coverage rate required to reach herd immunity.Abbreviation: EHI: Equivalized Household Income per month; SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2.
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Affiliation(s)
- Caroline Alleaume
- Southeastern Health Regional Observatory (ORS Paca), Faculté De Médecine, Marseille Cedex 5, France
| | - Pierre Verger
- Southeastern Health Regional Observatory (ORS Paca), Faculté De Médecine, Marseille Cedex 5, France.,Inserm, F-crin I Reivac, Toulouse, France
| | - Fadia Dib
- INSERM CIC 1417, F-CRIN, I REIVAC, Assistance Publique- Hôpitaux De Paris, Hôpital Cochin, Paris Cedex 14, France.,INSERM, Sorbonne Université, Institut Pierre Louis D'épidémiologie Et De Santé Publique, Paris, France
| | - Jeremy K Ward
- IRD, AP-HM, SSA, VITROME, IHU, Aix-Marseille University, Marseille, France.,CERMES3, Inserm, Villejuif, France
| | - Odile Launay
- Inserm, F-crin I Reivac, Toulouse, France.,INSERM CIC 1417, F-CRIN, I REIVAC, Assistance Publique- Hôpitaux De Paris, Hôpital Cochin, Paris Cedex 14, France
| | - Patrick Peretti-Watel
- Southeastern Health Regional Observatory (ORS Paca), Faculté De Médecine, Marseille Cedex 5, France.,IRD, AP-HM, SSA, VITROME, IHU, Aix-Marseille University, Marseille, France.,CERMES3, Inserm, Villejuif, France
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36
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Verger P, Scronias D. Changes in general practitioners' attitudes toward COVID-19 vaccination after first interim results: a longitudinal approach in France. Hum Vaccin Immunother 2021; 17:3408-3412. [PMID: 34254880 DOI: 10.1080/21645515.2021.1943990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
We assessed whether the a priori acceptance by French general practitioners (GPs) of COVID-19 vaccines changed after the announcements about them in November 2020. In all, between two surveys in October-November and in November-December 2020, acceptance of COVID-19 vaccines increased among 16.9% of GPs and decreased among 23.0%. Among those with high acceptance in October-November (52.5%), 11.6% became hesitant-reluctant in November-December; in those with initial hesitancy-reluctance (24.6%), 15.2% showed high acceptance. Deteriorating acceptance was significantly associated with GPs' distrust in the Ministry of Health and a priori concerns about the safety of vaccines developed during an epidemic; the reverse was found for improving acceptance. In addition, better acceptance was more likely among GPs who perceived the medical severity of COVID-19 to be high and was less common among women. During a severe pandemic, GPs' trust in health institutions and perception of safety issues remain important predictors of their attitudes toward new vaccines. Vigilance is needed regarding health professionals' reactions to events that may cast doubt on the safety or efficacy of certain COVID-19 vaccines. Personalized approaches should be considered and tested to address their concerns as the situation and knowledge evolve.
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Affiliation(s)
- Pierre Verger
- Faculty of Medicine, ORS PACA (Southeastern Health Regional Observatory), Marseille, France
| | - Dimitri Scronias
- Faculty of Medicine, ORS PACA (Southeastern Health Regional Observatory), Marseille, France.,Centre d'investigation Clinique de l'Hôpital Cochin-Pasteur (CIC 1417), Assistance Publique des Hôpitaux de Paris, Paris, France
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Abstract
An often-stated public health comment is that "vaccination is a victim of its own success." While the scientific and medical consensus on the benefits of vaccination is clear and unambiguous, an increasing number of people are perceiving vaccines as unsafe and unnecessary. The World Health Organization identified "the reluctance or refusal to vaccinate despite availability of vaccines" as one of the 10 threats to global health in 2019. The negative influence of anti-vaccination movements is often named as a cause of increasing vaccine resistance in the public. In this review, we give an overview of the current literature on the topic, beginning by agreeing on terminology and concepts before looking at potential causes, consequences, and impacts of resistance to vaccination.
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Affiliation(s)
- Ève Dubé
- Centre de Recherche du CHU de Québec, Université Laval, Québec G1V 4G2, Canada.,Institut National de Santé Publique du Québec, Québec G1E 7G9, Canada;
| | - Jeremy K Ward
- CERMES3, INSERM, CNRS, EHESS, Université de Paris, 94076 Villejuif, France; .,Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, VITROME, 13005 Marseille, France;
| | - Pierre Verger
- Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, VITROME, 13005 Marseille, France; .,Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 13005 Marseille, France
| | - Noni E MacDonald
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia B3K 6R8, Canada;
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Verger P, Scronias D, Fradier Y, Meziani M, Ventelou B. Online study of health professionals about their vaccination attitudes and behavior in the COVID-19 era: addressing participation bias. Hum Vaccin Immunother 2021; 17:2934-2939. [PMID: 34047670 DOI: 10.1080/21645515.2021.1921523] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Online surveys of health professionals have become increasingly popular during the COVID-19 crisis because of their ease, speed of implementation, and low cost. This article leverages an online survey of general practitioners' (GPs') attitudes toward the soon-to-be-available COVID-19 vaccines, implemented in October-November 2020 (before the COVID-19 vaccines were authorized in France), to study the evolution of the distribution of their demographic and professional characteristics and opinions about these vaccines, as the survey fieldwork progressed, as reminders were sent out to encourage them to participate. Focusing on the analysis of the potential determinants of COVID-19 vaccine acceptance, we also tested if factors related to survey participation biased the association estimates. Our results show that online surveys of health professionals may be subject to significant selection bias that can have a significant impact on estimates of the prevalence of some of these professionals' behavioral, opinion, or attitude variables. Our results also highlight the effectiveness of reminder strategies in reaching hard-to-reach professionals and reducing these biases. Finally, they indicate that weighting for nonparticipation remains indispensable and that methods exist for testing (and correcting) selection biases.
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Affiliation(s)
- Pierre Verger
- ORS PACA (Southeastern Health Regional Observatory), Faculty of Medicine, Marseille, France
| | - Dimitri Scronias
- ORS PACA (Southeastern Health Regional Observatory), Faculty of Medicine, Marseille, France.,Centre D'investigation Clinique De l'Hôpital Cochin-Pasteur (CIC 1417), Assistance Publique Des Hôpitaux De Paris, Paris, France
| | | | | | - Bruno Ventelou
- ORS PACA (Southeastern Health Regional Observatory), Faculty of Medicine, Marseille, France.,Aix Marseille Université, CNRS, AMSE, Marseille, France
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Alleaume C, Verger P, Peretti-Watel P. Psychological support in general population during the COVID-19 lockdown in France: Needs and access. PLoS One 2021; 16:e0251707. [PMID: 34014974 PMCID: PMC8136662 DOI: 10.1371/journal.pone.0251707] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 05/02/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION With France one of the European countries most strongly affected by COVID-19 in the spring of 2020, French authorities imposed a nationwide lockdown for 8 weeks (March 17-May 10). This study explored the perception of the adult population about the need for-and access to-psychological support from health care professionals (HCP) in response to concerns about the psychological needs during lockdown. MATERIAL AND METHOD This online cross-sectional survey of a representative sample of the adult general population of mainland France (N = 2,003) took place during the last four days of the French lockdown (May 7-10, 2020). RESULTS One in eight respondents (12.2%) perceived a need for psychological support from an HCP during the lockdown; most had symptoms of depression and/or anxiety of at least moderate intensity. Only a third (29.8%, 3.6% of the entire sample) actually obtained this support. Factors associated with this perceived need included: age under 35, economic difficulties due to lockdown, pre-lockdown use of psychological support, infection with COVID-19, serious worries about becoming infected, and heavy media use to obtain information about the disease. Among those who perceived a need for psychological support, the elderly were the most likely not to consult an HCP. People aged 35-64, those with high income, and those seriously worried about developing COVID-19 were the most likely to forgo seeking access to care because of their fear of infection by the coronavirus-2019. CONCLUSION The perceived need for psychological support from an HCP and access to it appeared to be strongly associated with COVID-19 exposure factor. More research about this association is needed to improve the health authorities' understanding of the population's psychological needs in this situation and to enhance HCPs' abilities to meet them. In particular, further research of its specific impact on youth is necessary.
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Affiliation(s)
- Caroline Alleaume
- Southeastern Health Regional Observatory (ORS Paca), Marseille, France
| | - Pierre Verger
- Southeastern Health Regional Observatory (ORS Paca), Marseille, France
| | - Patrick Peretti-Watel
- Southeastern Health Regional Observatory (ORS Paca), Marseille, France
- Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France
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Abstract
France has been at the epicenter of the worldwide debate about hydroxychloroquine, as the main advocacy for its use to treat COVID-19 comes from a research unit led by Didier Raoult in Marseille. Among a national panel of 2940 general practitioners, we found that physicians in the areas most strongly affected by the epidemic or closest to the epicenter of the controversy reported that the hydroxychloroquine debate had made it difficult for them to deal with patients' treatment requests. Their adherence to official recommendations was also lower. It will be necessary to examine the conditions producing so strong a conflict.
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Affiliation(s)
- Romain Lutaud
- Département de médecine générale, Aix Marseille Univ, Marseille, France.,ORS PACA, Southeastern Health Regional Observatory (Observatoire régional de la santé Provence-Alpes-Côte d'Azur), Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Dimiti Scronias
- ORS PACA, Southeastern Health Regional Observatory (Observatoire régional de la santé Provence-Alpes-Côte d'Azur), Marseille, France.,Hôpital Cochin, Centre d'Investigation Clinique (CIC) Cochin Pasteur, APHP, Paris, France
| | - Jeremy Ward
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,INSERM, CERMES3, Paris, France
| | - Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory (Observatoire régional de la santé Provence-Alpes-Côte d'Azur), Marseille, France
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Davin-Casalena B, Jardin M, Guerrera H, J Mabille, Tréhard H, Lapalus D, Ménager C, Nauleau S, Cassaro V, Verger P, Guagliardo V. [The impact of the COVID-19 pandemic on first-line primary care in southeastern France: Feedback on the implementation of a real-time monitoring system based on regional health insurance data]. Rev Epidemiol Sante Publique 2021; 69:105-115. [PMID: 33992499 PMCID: PMC8075812 DOI: 10.1016/j.respe.2021.04.135] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/02/2021] [Accepted: 04/12/2021] [Indexed: 12/13/2022] Open
Abstract
Position du problème L’épidémie de COVID-19 du printemps 2020 a fortement affecté le système de soins. Le confinement et les risques d’exposition au coronavirus ont incité les patients à modifier leur recours aux soins. L’objectif était de partager un retour d’expérience sur la mise en place d’un dispositif de surveillance en temps réel de l’activité des médecins libéraux de la région Provence-Alpes-Côte d’Azur, et de l’évolution des remboursements de médicaments prescrits aux assurés du régime général pour le diabète, pour des troubles de la santé mentale et pour certains vaccins. Méthodes Les données ont été extraites à partir des bases régionales de l’Assurance maladie pour les années 2019 et 2020. Elles ont permis de construire des indicateurs en date de soins pour le régime général stricto sensu, calculés de façon hebdomadaire, à partir de la semaine 2. Résultats On constate une chute d’activité des médecins libéraux lors du confinement (−23 % pour les médecins généralistes ; −46 % pour les spécialistes), suivie d’un quasi retour à la normale par la suite. Dans le même temps, les téléconsultations ont connu un véritable essor : elles ont constitué 30 % des actes des médecins libéraux au plus fort de la crise. Le début du confinement a été marqué par un pic d’approvisionnement en médicaments, tandis que la vaccination a fortement diminué (−39 % concernant le vaccin contre la rougeole, les oreillons et la rubéole chez les enfants âgés de moins de 5 ans ; −54 % pour le vaccin contre les papillomavirus humains chez les filles âgées de 10–14 ans). Conclusion L’épidémie de COVID-19 risque d’entraîner d’autres conséquences sanitaires que celles directement imputables à la COVID-19 elle-même. Le renoncement aux soins pourrait causer des retards de soins fortement préjudiciables aux individus et à la collectivité. Ces questions inquiètent les autorités publiques, qui mettent en place des actions visant à inciter les patients à se soigner sans tarder. Mais la crise liée à la COVID-19 a aussi créé des opportunités, telles que le déploiement de la téléconsultation et de la télé-expertise. Bien que partiels, les indicateurs mis en œuvre peuvent permettre aux décideurs publics d’être réactifs et de mettre en place certaines actions afin de répondre aux besoins de santé des populations.
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Affiliation(s)
- B Davin-Casalena
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France.
| | - M Jardin
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - H Guerrera
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - J Mabille
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - H Tréhard
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - D Lapalus
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - C Ménager
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - S Nauleau
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - V Cassaro
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - P Verger
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - V Guagliardo
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
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Gakuba C, Sar A, Gaborieau I, Hanouz JL, Verger P. Willingness to get a COVID-19 vaccine among critical care non-medical healthcare workers and impact of a vaccine information session. Anaesth Crit Care Pain Med 2021; 40:100860. [PMID: 33848874 PMCID: PMC8019251 DOI: 10.1016/j.accpm.2021.100860] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Clement Gakuba
- Normandie Univ, UNICAEN, CHU de Caen Normandie, Service d'Anesthésie Réanimations, 14000 Caen, France.; Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain at Caen-Normandie, Cyceron, 14000 Caen, France.
| | - Alexandre Sar
- Normandie Univ, UNICAEN, CHU de Caen Normandie, Service d'Anesthésie Réanimations, 14000 Caen, France..
| | - Isabelle Gaborieau
- Normandie Univ, UNICAEN, CHU de Caen Normandie, Service d'Anesthésie Réanimations, 14000 Caen, France..
| | - Jean-Luc Hanouz
- Normandie Univ, UNICAEN, CHU de Caen Normandie, Service d'Anesthésie Réanimations, 14000 Caen, France.; Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain at Caen-Normandie, Cyceron, 14000 Caen, France.
| | - Pierre Verger
- Aix Marseille Université, IRD, AP-HM,SSA, VITROME, IHU Méditerranée Infection, 19-21 bd Jean Moulin, 13005, Marseille, France; Southeastern Health Regional Observatory (ORS PACA), Marseille, France.
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Verger P, Dualé C, Scronias D, Lenzi N, Pulcini C, Launay O. Attitudes of hospital physicians toward childhood mandatory vaccines in France: A cross-sectional survey. Hum Vaccin Immunother 2021; 18:1870393. [PMID: 33616464 PMCID: PMC8920152 DOI: 10.1080/21645515.2020.1870393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Due to a decades-long crisis of confidence in vaccination, in 2017 France extended the number of mandatory early childhood vaccines from 3 to 11. Aims To describe the opinions of hospital staff physicians (HSPs) regarding this measure, quantify the proportion who would have preferred measures based on education, and study the factors associated with the latter opinion. Methods Cross-sectional nationwide survey with a standardized questionnaire in 2018–2019 among HSPs in 14 French public hospitals. The factors associated with HSPs’ preference for education and persuasion over mandatory vaccination were analyzed with simple and multiple Poisson regressions. Results The analyses included 1,795 HSPs (participation rate of 86%). Among them, 84% considered the extension of mandatory childhood vaccination essential given the epidemiological context at the time; in a later question, 40% would have preferred education and persuasion. Multiple regressions showed that the latter tended to be younger and less trustful of sources of information about vaccination. They were more likely to think that information on the rationale behind the national vaccination policy lacked clarity and that the extension of mandatory vaccines was not essential, even in the current epidemiologic situation. Conclusion Although most HSPs agreed that the extension of mandatory childhood vaccines was essential, some were ambivalent about its coercive philosophy. Further research is necessary to better understand the reasons of this ambivalence. A fraction did not understand the French vaccination strategy well. Efforts to explain its details to HSPs and an overhaul of their initial training on vaccination are still needed.
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Affiliation(s)
- Pierre Verger
- Research Department, Southeastern Health Regional Observatory (Observatoire Régional De La Santé Paca), Marseille, France.,INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France
| | - Christian Dualé
- INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France.,Centre Hospitalo-universitaire, Clermont-Ferrand, Centre d'Investigation Clinique, INSERM, Clermont-Ferrand, France
| | - Dimitri Scronias
- Faculté de Médecine Paris Descartes, Université de Paris, Paris, France.,INSERM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Nezha Lenzi
- INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France.,Faculté de Médecine Paris Descartes, Université de Paris, Paris, France.,INSERM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
| | - Céline Pulcini
- PEMAC, équipe MICS, Université de Lorraine, Nancy, France.,Infectious Diseases Department, Université de Lorraine, CHRU-Nancy, Nancy, France
| | - Odile Launay
- INSERM, F-CRIN, Innovative Clinical Research Network in VACcinology (I-REIVAC), Paris, France.,Faculté de Médecine Paris Descartes, Université de Paris, Paris, France.,INSERM, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, France
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Verger P, Peretti-Watel P. Understanding the determinants of acceptance of COVID-19 vaccines: a challenge in a fast-moving situation. Lancet Public Health 2021; 6:e195-e196. [PMID: 33556329 PMCID: PMC7864794 DOI: 10.1016/s2468-2667(21)00029-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 11/21/2022]
Affiliation(s)
- Pierre Verger
- Faculté des sciences médicales et paramédicales, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille 13 385, France.
| | - Patrick Peretti-Watel
- Faculté des sciences médicales et paramédicales, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille 13 385, France; UMR Vitrome, Mediterrannean Infection Institute, Aix-Marseille University, IRD
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Verger P, Scronias D, Dauby N, Adedzi KA, Gobert C, Bergeat M, Gagneur A, Dubé E. Attitudes of healthcare workers towards COVID-19 vaccination: a survey in France and French-speaking parts of Belgium and Canada, 2020. ACTA ACUST UNITED AC 2021; 26. [PMID: 33478623 PMCID: PMC7848677 DOI: 10.2807/1560-7917.es.2021.26.3.2002047] [Citation(s) in RCA: 230] [Impact Index Per Article: 76.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In October and November 2020, we conducted a survey of 2,678 healthcare workers (HCWs) involved in general population immunisation in France, French-speaking Belgium and Quebec, Canada to assess acceptance of future COVID-19 vaccines (i.e. willingness to receive or recommend these) and its determinants. Of the HCWs, 48.6% (n = 1,302) showed high acceptance, 23.0% (n = 616) moderate acceptance and 28.4% (n = 760) hesitancy/reluctance. Hesitancy was mostly driven by vaccine safety concerns. These must be addressed before/during upcoming vaccination campaigns.
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Affiliation(s)
- Pierre Verger
- ORS PACA (Southeastern Health Regional Observatory), Faculty of Medicine, Marseille, France
| | - Dimitri Scronias
- Centre d'investigation clinique de l'Hôpital Cochin-Pasteur (CIC 1417), Assistance Publique des Hôpitaux de Paris, Paris, France.,ORS PACA (Southeastern Health Regional Observatory), Faculty of Medicine, Marseille, France
| | - Nicolas Dauby
- Institute for Medical Immunology, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Centre for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Department of Infectious Diseases, CHU Saint-Pierre - Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Kodzo Awoenam Adedzi
- Centre de recherche du CHU de Québec - Université Laval, D'Estimauville, Quebec City, Canada
| | - Cathy Gobert
- General Practice, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Maxime Bergeat
- Maxime Bergeat (MS) - French Ministry for Solidarity and Health - Statistical Service (DREES), Paris, France
| | - Arnaud Gagneur
- Université de Sherbrooke-campus de la santé, Sherbrooke, Quebec, Canada.,Department of Pediatrics, centre de recherche du CHUS, Sherbrooke, Quebec, Canada
| | - Eve Dubé
- Anthropology Department, Laval University, Quebec City, Canada.,Centre de recherche du CHU de Québec - Université Laval, D'Estimauville, Quebec City, Canada
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Wilson RJI, Vergélys C, Ward J, Peretti-Watel P, Verger P. Vaccine hesitancy among general practitioners in Southern France and their reluctant trust in the health authorities. Int J Qual Stud Health Well-being 2021; 15:1757336. [PMID: 32400299 PMCID: PMC7269038 DOI: 10.1080/17482631.2020.1757336] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose: Vaccine hesitancy is common in France, including among general practitioners (GPs). We aimed to understand vaccine hesitant GPs’ views towards vaccines. Method: We conducted in-depth interviews that were thematically analysed. Result: We found that, facilitated by health scandals and vaccine controversies—that according to participants were not effectively handled by health authorities—the implicit contract existing between health authorities and GPs has been ruptured. This contract implies that health authorities support GPs in making vaccine recommendations by addressing GPs’ own concerns, providing them with adequate and up-to-date information and advice, and involving them in vaccine decision-making. In turn, GPs encourage vaccination to reach vaccine coverage targets. Conclusion: The rupture of this implicit contract has led to a breach in trust in the health authorities and the vaccines that they recommend.
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Affiliation(s)
- Rose Jane Isobel Wilson
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Chantal Vergélys
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Jeremy Ward
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,UMR 8236 (LIED), Université Paris Diderot, Paris, France
| | - Patrick Peretti-Watel
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Pierre Verger
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
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Costa M, Correard F, Montaleytang M, Baumstarck K, Loubière S, Amichi K, Villani P, Honore S, Daumas A, Verger P. Acceptability of a Novel Telemedication Review for Older Adults in Nursing Homes in France: A Qualitative Study. Clin Interv Aging 2021; 16:19-34. [PMID: 33442242 PMCID: PMC7800438 DOI: 10.2147/cia.s283496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 11/17/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose In France, polypharmacy among older people living in nursing homes (NH) is a major public health concern. In this context, the randomized controlled trial TEM-EHPAD was recently launched in various NH in southern France to evaluate the impact of implementing a novel telemedication review (TMR) on hospital admission rates of NH residents at high risk of iatrogenic disease. A qualitative study was integrated into the main trial study to assess general practitioners' (GP) and other NH healthcare professionals' (HP) acceptability of the proposed TMR before its implementation. Material and Methods A qualitative study using face-to-face semi-structured interviews was conducted with 16 HP before the beginning of the intervention. A manual thematic analysis was performed on the transcribed interviews. Results Four main themes emerged from the thematic analysis: HP perceptions of the TMR, difficulties related to medication management for NH residents, HP perceptions of the roles of different professionals, and facilitators of good practices. Most participants were favorable to the TMR, but some GP expressed fears about loss of control over their prescription writing. Conclusion This study fulfilled its objective to assess pre-intervention acceptability by GP and other HP. Results provided important information about how to adapt the TMR intervention to make it more acceptable to HP who will be involved in TEM-EHPAD. One of the main recommendations is the importance of providing participating GP with the opportunity to take part in the process of reviewing prescriptions.
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Affiliation(s)
- Marie Costa
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
| | - Florian Correard
- AP-HM, Service Pharmacie, Hôpital de la Timone, Marseille 13385, France.,Laboratoire de Pharmacie Clinique, faculté de pharmacie, Aix-Marseille Université, Marseille 13385, France
| | - Maeva Montaleytang
- AP-HM, Service Pharmacie, Hôpital de la Timone, Marseille 13385, France.,Laboratoire de Pharmacie Clinique, faculté de pharmacie, Aix-Marseille Université, Marseille 13385, France
| | - Karine Baumstarck
- EA3279, Self-Perceived Health Assessment Research Unit, Aix-Marseille University, Marseille 13385, France
| | - Sandrine Loubière
- EA3279, Self-Perceived Health Assessment Research Unit, Aix-Marseille University, Marseille 13385, France
| | - Kahena Amichi
- Direction de la Recherche Clinique et de l'Innovation (DRCI), AP-HM, Marseille 13354, France
| | - Patrick Villani
- Service de Médecine Interne Gériatrie et Thérapeutique, CHU Sainte Marguerite, Assistance Publique des Hôpitaux de Marseille (AP-HM), Marseille 13274, France
| | - Stephane Honore
- AP-HM, Service Pharmacie, Hôpital de la Timone, Marseille 13385, France.,Laboratoire de Pharmacie Clinique, faculté de pharmacie, Aix-Marseille Université, Marseille 13385, France.,Service de Pharmacie Clinique, Faculté de Pharmacie Timone, Aix-Marseille Université, Marseille F-13000, France
| | - Aurélie Daumas
- Service de Médecine Interne Gériatrie et Thérapeutique, CHU Sainte Marguerite, Assistance Publique des Hôpitaux de Marseille (AP-HM), Marseille 13274, France
| | - Pierre Verger
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
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Bouchez M, Ward JK, Bocquier A, Benamouzig D, Peretti-Watel P, Seror V, Verger P. Physicians’ decision processes about the HPV vaccine: A qualitative study. Vaccine 2021; 39:521-528. [DOI: 10.1016/j.vaccine.2020.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 10/22/2022]
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Peretti-Watel P, Verger P, Launay O. The French general population's attitudes toward lockdown against COVID-19: a fragile consensus. BMC Public Health 2020; 20:1920. [PMID: 33339543 PMCID: PMC7746918 DOI: 10.1186/s12889-020-10048-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 12/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In March 2020, as the coronavirus disease 2019 (COVID- 19) pandemic was spreading across the globe, many countries have implemented unprecedented lockdown measures. But how populations did react to these measures? We examined the case of France. Our aims were threefold: assessing some aspects of their impact on French's daily living conditions; investigating their attitudes toward the lockdown; investigating the factors associated with these attitudes. METHODS A cross-sectional online survey was carried out 10 days after the nationwide lockdown (from March 27th to March 29th 2020), among a representative sample of the mainland French population aged 18 and over. A quota sampling method was applied to achieve a sample of 1012 respondents. We used a cluster analysis to obtain contrasted attitudinal profiles, and logistic regressions to investigated which factors were associated to these profiles. RESULTS After 10 days of lockdown, there were already significant consequences regarding respondents' living conditions and mental health. Most respondents supported the current lockdown. However, it appeared as a stopgap measure due to a lack of alternatives, and a large majority acknowledged its heavy drawbacks. We found three contrasted attitudinal profiles: full support (38%), strong but critical support (31%), limited support (31%). Regarding respondents' SES, low-income and low-education respondents were more likely to display critical or limited support to the lockdown, as well as those who reported deteriorated living conditions or psychological distress. CONCLUSIONS In France, the large public support to the lockdown was fragile. First, it was a critical consensus anchored in current controversies and recent social struggles. Second, it was weaker among people with a lows SES, especially since the lockdown have exacerbated preexisting social inequalities.
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Affiliation(s)
- Patrick Peretti-Watel
- Aix Marseille Université, IRD, AP-HM, SSA, VITROME, IHU Méditerranée Infection, 19-21 bd Jean Moulin, 13005, Marseille, France. .,Southeastern Health Regional Observatory (ORS Paca), Marseille, France.
| | - Pierre Verger
- Aix Marseille Université, IRD, AP-HM, SSA, VITROME, IHU Méditerranée Infection, 19-21 bd Jean Moulin, 13005, Marseille, France.,Southeastern Health Regional Observatory (ORS Paca), Marseille, France
| | - Odile Launay
- Inserm CIC 1417, Faculté de Médecine Paris Descartes, Univ Paris, AP-HP, Hôpital Cochin, Paris, France
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