Healthcare Providers’ Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review

Background: Vaccine hesitancy decreases adult vaccination coverage and has been recognized by WHO as a major health threat. Primary care physicians (PCP) play a key role in vaccination by giving vaccine counselling to their patients. The aim of this systematic review is to identify the knowledge, beliefs, attitudes and barriers (KBAB) associated with own vaccination and patient recommendation in primary care physicians. Methods: MEDLINE/PubMed, EMBASE and Cochrane Library databases were used to search and identify relevant studies based on their title and abstract. In the next step, the full text of each previously selected article was read for eligibility. Articles were selected by two independent reviewers and data extraction was performed using tables. The following information was extracted: methodological characteristics, demographic factors, professional characteristics, and intrinsic or extrinsic factors influencing vaccination or recommendation. Results: Our search yielded 41 eligible papers, data-sources, previous practices, belief in the effectiveness or safety of the vaccine, perceived risk, and trust in health authorities were all shown to be related to own vaccination and patient recommendation. Conclusion: Internet is the main source of information for PCP related to vaccine hesitancy. It is therefore essential to increase the presence and access to pro-vaccination content in this area. In addition, involving PCP in the establishment of vaccination recommendations could improve their credibility in the institutions. On the other hand, training in communication skills and establishing reminder systems could reflect higher vaccination coverage among their patients.

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Understanding Primary Care Physician Vaccination Behaviour: A Systematic Review

Oncological patients are susceptible to various severe viral infections, including influenza. Vaccinating oncological patients and their household contacts (“cocoon vaccination”) may protect these patients from contracting influenza. To understand the potential of cocoon vaccination in oncological patients, this study assesses the influenza vaccination status of oncological patients and their household contacts and their considerations regarding the vaccination. In this retrospective study, oncological patients with a solid tumor were asked to fill in a questionnaire about their own and their household contacts’ influenza vaccination status in the influenza season of 2018–2019. Ninety-eight patients were included (response rate 88%). The influenza vaccination rates of oncological patients and their first household contacts were 43.9% and 44.9%, respectively. The majority of vaccinated patients and vaccinated first household contacts had been advised by their general practitioner to get the vaccination. A minority of the first household contacts reported getting vaccinated specifically because of the patient’s vulnerability. Unvaccinated patients and unvaccinated household contacts mainly believed the vaccination was unnecessary or were afraid of side effects. None of the included patients had been hospitalized with influenza. The oncological patients’ and first household contacts’ vaccination rates in this study were lower than the vaccination rates of the general Dutch population of over 60 years old, possibly due to a lack of knowledge and misconceptions about the vaccination. Further research is required to establish whether cocoon vaccination can contribute to protecting oncological patients from contracting an influenza infection.

/pdf/cocoon-vaccination-for-influenza-in-patients-with-a-solid-3za5leajo0.pdf

Cocoon vaccination for influenza in patients with a solid tumor: a retrospective study

Vaccination coverage in hematological patients undergoing chemotherapy: Should we move towards personalized vaccination?

This study aimed to evaluate clinical pharmacist's contribution to the pneumococcal vaccination rate by providing education to cancer patients in hospital settings.This study was conducted in 2 tertiary-care hospitals' medical oncology outpatient clinics. Patients over 18 years of age and diagnosed with cancer for less than 2 years, in remission stage, and have not previously received the pneumococcal vaccine were included. Patients were randomized to intervention and control groups. The intervention group was provided vaccination education and recommended to receive the PCV13 vaccine. The control group received routine care. Patients' knowledge about pneumonia/pneumococcal vaccine, Vaccine Attitude Examination Scale (VAX) score, and vaccination rates were evaluated at baseline and 3 months after the education.A total of 235 patients (intervention: 117, control: 118) were included. The mean age ± SD was 57.86 ± 11.88 years in the control and 60.68 ± 11.18 years in the intervention groups. The numbers of correct answers about pneumonia/pneumococcal vaccine (p = 0.482) and VAX scores (p = 0.244) of the groups were similar at baseline. After the intervention, the median (IQR) number of correct answers in intervention group [10(3)] was higher than control group [8(4)] (p < 0.001). After the education, the total VAX score (mean ± SD) was less in intervention group (33.09 ± 7.018) than the control group (36.07 ± 6.548) (p = 0.007). Three months after the education, 20.2% of the patients in the intervention and 6.1% in the control groups were vaccinated with pneumococcal vaccine (p = 0.003).The pneumococcal vaccination rate in cancer patients has increased significantly by the education provided by a clinical pharmacist in hospital settings. 

/pdf/impact-of-pharmacist-led-educational-intervention-on-3e5nrl2z.pdf

Impact of pharmacist-led educational intervention on pneumococcal vaccination rates in cancer patients: a randomized controlled study

Objectives Despite specific recommendations issued by the French Public Health Council (Haut Conseil de Sante Publique), the vaccination coverage of patients with cancer or malignant blood disease remains insufficient. The aim of this study was to assess the vaccination of chemotherapy patients by their general practitioner (GP). Methods A survey was conducted between March and July 2017 in 4 French departments to describe the immunization practices of GPs for their chemotherapy patients and provide solutions to help to increase the vaccination rate. Results Of the 1610 GPs who received the questionnaire, 287 (17.8%) returned a usable form; 92.6% were globally pro-vaccine. One third of GPs (37.3%) declared that they vaccinated all their chemotherapy patients. The GPs (n = 180) who never or only sometimes vaccinated their chemotherapy patients mainly voiced concerns about not being properly trained (45.6%) and the lack of easily available information on vaccination (35.0%). Three-quarters (n = 212; 74%) of the GPs wanted to improve their level of medical knowledge via continuing education (52.4%) or by reading guidelines available on-line (39.6%). GPs suggested that a specific vaccination schedule be included in the letter they receive from the cancer specialist (72.8%) and that patient awareness be increased (50.5%). Conclusions GPs are in favor of the vaccination of cancer patients. The main obstacles stated are the lack of education and the lack of easily available information. Vaccination coverage could be increased by improving the doctor-to-doctor relation between GPs and cancer specialists.

Vaccination of cancer patients treated with chemotherapy: A survey among general practitioners.

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Vaccination of cancer patients treated with chemotherapy: A survey among general practitioners.