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. 2024 Nov 26;25(1):402.
doi: 10.1186/s12875-024-02647-3.

Pertussis vaccination in adults: a behavioral study of physicians from the US, France, and Germany

Donald Middleton  1 , Liana Clark  2 , Anne Mosnier  3 , Ulrich Heininger  4
Affiliations

Pertussis vaccination in adults: a behavioral study of physicians from the US, France, and Germany

Donald Middleton et al. BMC Prim Care. .

Abstract

Background: Pertussis is a highly contagious respiratory tract infection that affects all ages, though it is most severe in young infants. Adults, especially those with respiratory conditions or other chronic illnesses can also suffer serious consequences of pertussis. Pertussis vaccination is the best method of disease prevention in a lifetime. This behavioral study aimed to assess physicians' attitudes towards pertussis vaccination in adults and the importance of pertussis vaccination for disease prevention, especially in those with chronic illnesses, and to determine the impact of the COVID-19 pandemic on adult vaccination behaviors.

Methods: Between November 2022 and January 2023, physicians from the US, France, and Germany registered in an independent online database were contacted to participate in this study. After eligibility screening, participating physicians completed an online questionnaire addressing topics related to physician recommendations and vaccination behavior around pertussis in adults.

Results: Eight hundred physicians participated in the study (US: 400; France: 200; Germany: 200). Physicians' attitudes towards pertussis vaccination in adults were broadly similar between the countries. Overall, 65% of physicians believed in the importance of vaccination against pertussis, a lower proportion than for COVID-19 (82%), influenza (81%), pneumococcal disease (76%), and tetanus (73%). Physicians considered immunocompromised adults or those with chronic obstructive pulmonary disease (COPD), asthma, or other respiratory conditions to be at greatest risk from pertussis. Physicians estimated that two-thirds of the adult patients to whom they recommended pertussis vaccination agreed to receive it. The top reason why they felt patients did not receive pertussis vaccination as recommended was low perception of personal risk for pertussis. Physicians' pertussis vaccination behavior was found to be similar before and after the COVID-19 pandemic.

Conclusions: While physicians in the surveyed countries recognized the value of pertussis vaccination in adults, they ranked its importance lower than that of other adult vaccines. Physicians recognized the need to immunize vulnerable adults who are at risk of severe pertussis, such as those with asthma and/or COPD, but this awareness frequently did not result in vaccination of these priority groups, especially without official recommendations to support such vaccination in these groups.

Keywords: Attitudes; Bordetella pertussis; Chronic illnesses; International; Pertussis vaccination; Pertussis vaccine; Physician behavior; Physician recommendations; Tdap; Whooping cough.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Human Ethics approval was not applicable. Informed consent was obtained from all participants. The study was carried out in accordance with relevant guidelines and regulations. Consent for publication: Informed consent was obtained from all participants. Competing interests: DM has been an advisor on vaccines for Merck, GSK, Pfizer, Sanofi, CSL Seqirus, Novavax, Moderna, Dynavax, and Valneva. He has also been a speaker for CSL Seqirus, Pfizer, and Sanofi. LC is an employee at Sanofi. AM declares the following relationships with the pharmaceutical industry as part of being an Open Rome employee, without any individual benefit: participation in influenza or vaccination advisory boards or lectures at meetings (Sanofi, Viatris, CSL Seqirus, IQVIA); and invitation to conferences (Sanofi). Besides this, she is a member of the influenza group of the French Microbiology Society (SFM). UH declares receiving consulting fees for the Global Pertussis Initiative (Sanofi), the Central and Eastern Europe Pertussis Awareness Group (Sanofi), and for pertussis consultation (GSK). He received product-independent lectures fees from GSK, InfectoPharm, Merck, Moderna, Pfizer, Roche, and Sanofi. He also participated in the Data Monitoring Committees of a poliomyelitis vaccine (Takeda), a Phase II study of an adjuvanted pandemic influenza vaccine (GSK/Watermark), the Norovirus Bivalent VLP Vaccine Program (Takeda/HilleVax), and the Cell-based Quadrivalent Influenza Vaccine (Seqirus QIV). Ulrich Heininger sits on the Meta Data Safety Monitoring Board for the Coalition for Epidemic Preparedness Innovations and has been a member of the Varicella Advisory Board, Switzerland (Merck) for the period 2000–2022. Besides this, he was a member of Ständige Impfkommission (Standing Committee on Vaccination) in Germany from 2001 until March 2024. He is currently the President of the Pediatric Infectious Disease Group of Switzerland and is a member and past Chair of the Committee for Infectious Diseases and Vaccines, Bündnis Kinder- und Jugendgesundheit (formerly the German Academy of Pediatrics), Germany (all without financial support).

Figures

Fig. 1
Fig. 1
Physician flow chart. a Also includes physicians who were excluded during quality check. b Excluded from study as their specialty or country quota had already been fulfilled, or if they did not complete the questionnaire
Fig. 2
Fig. 2
Physicians’ perception of diseases that require vaccination, ranked in order of need to vaccinate. Response to the study question ‘What is your perception of the need to vaccinate against the following diseases when thinking of your adult patients?’
See this image and copyright information in PMC

References

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