Journal Article

Low Acceptability of A/H1N1 Pandemic Vaccination in French Adult Population: Did Public Health Policy Fuel Public Dissonance?

Moatti, Jean-Paul, Schwarzinger, Michaël, Cortarenoda, Sébastien, Flicoteaux, Rémi, Obadia, Yolande

2010

Overview

In July 2009, French public health authorities embarked in a mass vaccination campaign against A/H1N1 2009 pandemic-influenza. We explored the attitudes and behaviors of the general population toward pandemic vaccination. We conducted a cross-sectional online survey among 2,253 French representative adults aged 18 to 64 from November 17 to 25, 2009 (completion rate: 93.8%). The main outcome was the acceptability of A/H1N1 vaccination as defined by previous receipt or intention to get vaccinated (\"Yes, certainly\", \"Yes, probably\"). Overall 17.0% (CI 95%, 15.5% to 18.7%) of respondents accepted A/H1N1 vaccination. Independent factors associated with acceptability included: male sex (p = .0001); older age (p = .002); highest or lowest level of education (p = .016); non-clerical occupation (p = .011); having only one child (p = .008); and having received seasonal flu vaccination in prior 3 years (p<.0001). Acceptability was also significantly higher among pregnant women (37.9%) and other at risk groups with chronic diseases (34.8%) (p = .002). Only 35.5% of respondents perceived A/H1N1 influenza illness as a severe disease and 12.7% had experienced A/H1N1 cases in their close relationships with higher acceptability (p<.0001 and p = .006, respectively). In comparison to 26.0% respondents who did not consult their primary care physician, acceptability was significantly higher among 8.0% respondents who were formally advised to get vaccinated, and lower among 63.7% respondents who were not advised to get vaccinated (respectively: 15.8%, 59.5% and 11.7%- p<.0001). Among respondents who refused vaccination, 71.2% expressed concerns about vaccine safety. Our survey occurred one week before the peak of the pandemic in France. We found that alarming public health messages aiming at increasing the perception of risk severity were counteracted by daily personal experience which did not confirm the threat, while vaccine safety was a major issue. This dissonance may have been amplified by having not involved primary care physicians in the mass vaccination campaign.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acceptability / Adult / Adults / Analysis / At risk populations / Chronic diseases / Chronic illnesses / Female / France / Health care / Health policy / Health risks / Humanities and Social Sciences / Humans / Immunization / Immunization Programs / Immunization Programs - statistics & numerical data / Infectious Diseases/Respiratory Infections / Infectious Diseases/Viral Infections / Influenza / Influenza A Virus, H1N1 Subtype / Influenza vaccines / Library and information sciences / Life Sciences / Male / Mass Vaccination / Mass Vaccination - statistics & numerical data / Medical personnel / Motivation / Pandemics / Pandemics - prevention & control / Patient Acceptance of Health Care / Patient Acceptance of Health Care - statistics & numerical data / Patient Compliance / Patient Compliance - statistics & numerical data / Physicians / Pregnancy / Pregnant women / Primary care / Public health / Public Health and Epidemiology/Health Policy / Public Health and Epidemiology/Health Services Research and Economics / Public Health and Epidemiology/Immunization / Public Health and Epidemiology/Infectious Diseases / Public Health and Epidemiology/Social and Behavioral Determinants of Health / Public Policy / Risk groups / Risk perception / Safety / Santé publique et épidémiologie / Science Policy / Sociology / Surveys / Swine flu / Vaccination / Vaccines