A(H1N1) pandemic influenza and its prevention by vaccination: paediatricians' opinions before and after the beginning of the vaccination campaign

Abstract

Background: In June 2009, the World Health Organization declared an A(H1N1) influenza pandemic. In October 2009, the largest vaccination campaign in Canadian history began. The aim of this study was to document paediatricians' knowledge, attitudes and practices (KAP) regarding A(H1N1) pandemic influenza and its prevention by vaccination just after the beginning of the A(H1N1) vaccination campaign and to compare the results with those obtained before campaign initiation.

Methods: A self-administered mail-based questionnaire was sent to all Canadian paediatricians. Questionnaires were analyzed in two subsets: those received before and after the beginning of the vaccination campaign.

Results: Overall the response rate was 50%. Respondents' characteristics were comparable between the two subsets. Before the beginning of the campaign, 63% of paediatricians perceived A(H1N1) pandemic infection as a serious disease, that would occur frequently without vaccination compared to more than 75% after. Before the vaccination campaign, half of respondents or less thought that the A(H1N1) vaccine was safe (50%) and effective (35%) compared to 77% and 72% after. The proportion of paediatricians who reported they had received sufficient information on A(H1N1) vaccine increased from 31% before to 73% after the beginning of the vaccination campaign. The majority of respondents intended to get vaccinated against A(H1N1) influenza themselves (84% before and 92% after). Respondents' intention to recommend the A(H1N1) vaccine to their patients increased from 80% before the beginning of the campaign to 92% after. In multivariate analysis, the main determinants of paediatricians' intention to recommend the A(H1N1) vaccine were their intention to get vaccinated against A(H1N1) influenza themselves and a belief that A(H1N1) vaccine would be well accepted by health professionals who administer vaccines to the public.

Conclusion: Results of this study show important increases in physicians' level of confidence about A(H1N1) vaccine's safety and immunogenicity and their willingness to recommend this vaccine to their patients. These changes could be explained, at least partially, by the important effort done by public health authorities to disseminate information regarding A(H1N1) vaccination.

Figure 1

Correlations' graph between variables and the first and second principal components. Total percentage of the variability explained by first and second principal components was 13.6%. Variables almost uncorrelated with first and second principal components aren't represented on the graph, except subset variable (S). The variables: B, C, F, G, J contributed more to first and second principal components than others. - J: Respondent's intention to recommend A(H1N1) pandemic vaccine to their patients - G: "Belief that A(H1N1) vaccine will be effective" - F: "Belief that A(H1N1) vaccine will be safe" - C: "Belief that A(H1N1) pandemic influenza is a serious disease" - B: "Belief that seasonal influenza vaccines are very useful to protect children health" All variables, including variables almost uncorrelated with first and second principal component, are listed in an additional file (see Additional File 1).