title: Correlates of general practitioners' recommendations to patients regarding vaccination for the 2009-2010 pandemic influenza (A/H1N1) in France: implications for future vaccination campaigns.
abstract: BACKGROUND
  General practitioners' (GPs) recommendations to their patients regarding influenza vaccination is a key determinant of patient uptake of influenza vaccination.
  
  
  OBJECTIVE
  To study factors associated with GPs' recommendations regarding pandemic vaccination (pvaccination) to adults ≤65 years of age (hereafter referred to as adults) at risk and not at risk of severe complications of the 2009-2010 A/H1N1 influenza.
  
  
  METHODS
  National cross-sectional survey of 1431 French GPs. Pvaccination recommendations by GPs to adults were studied according to three categories: recommended pvaccination to at-risk adults only; recommended pvaccination to all adults; recommended against pvaccination or did not provide any advice to any adult.
  
  
  RESULTS
  GPs were more likely to recommend pvaccination to at-risk than not-at-risk adults (73.4% vs 40.1%, p<0.01). GPs who consulted official sources of information rather than news media during the pandemic were more likely to recommend pvaccination to at-risk adults only (OR=1.78; CI 95%=1.27-2.48) and to all adults (OR=2.03; CI 95%=1.42-2.92) than other GPs. GPs' unfavorable perceptions of the risk/efficacy balance of the pandemic vaccine (pvaccine) together with their perceptions of the low severity of the disease were negatively associated with recommending pvaccination. Hospitalization of GPs' patients because of the influenza was specifically associated with pvaccine recommendation to all adults (OR=2.81; CI 95%=1.98-3.99) but not with pvaccine recommendation to at-risk adults only.
  
  
  CONCLUSIONS
  In the pandemic context, GPs' perceptions of disease severity and the risk/efficacy balance of the pvaccine were the major determinants of French GPs recommending pvaccination or not. To increase the general public's acceptability of vaccination policies, GPs should be adequately informed about the course of the epidemics and the safety of the vaccine.
authors.affiliation: IAME (Infection, Antimicrobien, Modélisation, Evolution), UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France; Département de Biostatistique et Information Médicale, UMR-S717, Hôpital Saint Louis, APHP, Paris, France. Electronic address: remi.flicoteaux@sls.aphp.fr.
authors.forename: Rémi
authors.initials: R
authors.lastname: Flicoteaux
authors.affiliation: Université Nice-Sophia Antipolis, Faculté de Médecine de Nice, Nice, France; CHU de Nice, Service d'Infectiologie, Nice, France; Aix Marseille Université (Aix Marseille School of Economics-SESSTIM UMR 912, INSERM, IRD), Marseille, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Pulcini
authors.affiliation: Aix Marseille Université (Aix Marseille School of Economics-SESSTIM UMR 912, INSERM, IRD), Marseille, France; ORS PACA (Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur), Marseille, France.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Carrieri
authors.affiliation: IAME (Infection, Antimicrobien, Modélisation, Evolution), UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France; IAME, UMR 1137, INSERM, Paris, France.
authors.forename: Michael
authors.initials: M
authors.lastname: Schwarzinger
authors.affiliation: IAME (Infection, Antimicrobien, Modélisation, Evolution), UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France; IAME, UMR 1137, INSERM, Paris, France; AP-HP (Assistance Publique des Hôpitaux de Paris), Unité de Coordination du Risque Epidémique et Biologique, Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Leport
authors.affiliation: Aix Marseille Université (Aix Marseille School of Economics-SESSTIM UMR 912, INSERM, IRD), Marseille, France; ORS PACA (Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur), Marseille, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Verger
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D058005:General Practitioners / Q000523:psychology / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines
keywords: Attitudes; General practitioners; H1N1 subtype; Health knowledge; Influenza A virus; Mass vaccination; National health policy; Practice