Attitudes of the general public and general practitioners in five countries towards pandemic and seasonal influenza vaccines during season 2009/2010

Abstract

Background: Vaccination coverage rates for seasonal influenza are not meeting national and international targets. Here, we investigated whether the 2009/2010 A/H1N1 pandemic influenza affected the uptake of influenza vaccines.

Methodology/principal findings: In December 2009/January 2010 and April 2010, 500 randomly selected members of the general public in Germany, France, the United States, China, and Mexico were surveyed by telephone about vaccination for seasonal and A/H1N1 pandemic influenza. Also, in April 2010, 100 randomly selected general practitioners were surveyed. Adult vaccine coverage in December 2009/January 2010 for A/H1N1 pandemic and seasonal influenza were, respectively, 12% and 29% in France, 11% and 25% in Germany, 41% and 46% in the US, 13% and 30% in Mexico, and 12% and 10% in China. Adult uptake rates in April 2010 were higher in Mexico but similar or slightly lower in the other countries. Coverage rates in children were higher than in adults in the US, Mexico, and China but mostly lower in Germany and France. Germans and French viewed the threat of A/H1N1 pandemic influenza as low to moderate, whereas Mexicans, Americans, and Chinese viewed it as moderate to serious, opinions generally mirrored by general practitioners. The recommendation of a general practitioner was a common reason for receiving the pandemic vaccine, while not feeling at risk and concerns with vaccine safety and efficacy were common reasons for not being vaccinated. Inclusion of the A/H1N1 pandemic strain increased willingness to be vaccinated for seasonal influenza in the United States, Mexico, and China but not in Germany or France.

Conclusions/significance: The 2009/2010 A/H1N1 influenza pandemic increased vaccine uptake rates for seasonal influenza in Mexico but had little effect in other countries. Accurate communication of health information, especially by general practitioners, is needed to improve vaccine coverage rates.

Figure 1. Top five difference in opinions between people vaccinated and unvaccinated for A/H1N1 pandemic influenza.

General public respondents (n = 500 per country) were asked to score between 0 (totally disagree) to 10 (totally agree) with the following statements: “In most cases, A/H1N1 flu is a mild disease”, “The A/H1N1 flu vaccine works well/is efficacious”, “A/H1N1 flu vaccine is not necessary since there are effective medications to treat the A/H1N1 flu”, “The A/H1N1 flu vaccination is recommended by my physician”, “I am afraid of serious adverse reactions with A/H1N1 flu vaccine”, “A/H1N1 flu can send me to hospital”, “A/H1N1 flu vaccine is painful”, “I do not trust vaccines”, “The risk that I contract A/H1N1 flu is high”, “The A/H1N1 flu virus is mutating”, “The A/H1N1 flu vaccination is recommended by the government”, “I am healthy, I don't need it”, “It takes too much time/too complicated to get vaccinated”, “It is too expensive to get vaccinated”, “The number of A/H1N1 flu cases continues to rise dramatically”, “A/H1N1 flu complications are more severe in children than for adults”, “I would be much less likely to obtain a A/H1N1 flu vaccine if I had to pay out of pocket for the vaccine (no insurance/insurance does not cover)”, “I am confident with adjuvanted vaccine”, “I trust in the efficacy of vaccines”. Shown are the mean scores for the top five differences between vaccinated and unvaccinated individuals.