Abstract Background Vaccination of healthcare workers (HCW) aims to protect them and to reduce transmission to susceptible patients. Influenza, measles, pertussis, and varicella vaccinations are recommended but not mandatory for HCW in France. Insufficient vaccine coverage for these diseases in HCW has raised the question of introducing mandatory vaccination. We conducted a survey to estimate acceptability of mandatory vaccination for these four vaccines by HCW working in healthcare facilities (HCF) in France, and to identify associated determinants. Methods In 2019, we performed a cross-sectional survey of physicians, nurses, midwives and nursing assistants working in HCF in France using a randomised stratified three-stage sampling design (HCF type, ward category, HCW category). Data were collected in face-to-face interviews using a tablet computer. We investigated the possible determinants of acceptability of mandatory vaccination using univariate and multivariate Poisson regressions, and estimated prevalence ratios (PR). Results A total of 8594 HCW in 167 HCF were included. For measles, pertussis, and varicella, self-reported acceptability of mandatory vaccination (very or quite favourable) was 73.1% [CI95%: 70.9–75.1], 72.1% [69.8–74.3], and 57.5% [54.5–57.7], respectively. Acceptability varied according to i) HCW and ward category for these three vaccinations, ii) age group for measles and pertussis, and iii) sex for varicella. For mandatory influenza vaccination, acceptability was lower (42.7% [40.6–44.9]), and varied greatly between HCW categories (from 77.2% for physicians to 32.0% for nursing assistants). Conclusion HCW acceptability of mandatory vaccination was high for measles, pertussis and varicella but not as high for influenza. Vaccination for COVID-19 is mandatory for HCW in France. Replication of this study after the end of the COVID-19 crisis would help assess whether the pandemic had an impact on their acceptability of mandatory vaccination, in particular for influenza.
UNSTRUCTURED Background. Despite substantial screening for HIV, Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections in France, a great number of infected persons remain undiagnosed. In this context, Santé publique France experimented with a new screening approach for HBV, HCV, and HIV infection, based on home self-sampling using dried blood spot (DBS) for blood collection. The objectives of the BaroTest study were to assess the acceptability and feasibility of this approach and to update the prevalence estimates of HBV, HCV, and HIV infections in the general population. Methods/design. Participants were enrolled using the 2016 Health Barometer, a national cross-sectional telephone survey based on a large representative sample of the general population aged 15 to 75 years (N=15000). Upon completion of the questionnaire, eligible persons were invited to receive a self-sampling kit delivered by standard postal mail and to return the DBS card to the laboratory. The laboratory then was responsible for reporting the results to the study participant. Acceptability of the protocol was based on the percentage of eligible individuals agreeing to receive the self-sampling kit, on the proportion of people returning the DBS card and, finally, on the proportion of participants out of the total eligible population. The feasibility of the approach was based on the number of participants with adequately filled blood spots and the number of participants with blood spots for which at least one virological analysis could be performed. A complex system of reminders was implemented to increase the participation rate. Accordingly, we assumed that 35% of eligible persons would accept and return their DBS card, representing approximately 5,000 individuals. Since the highest expected prevalence was for HBV infection, estimated at 0.65% in 2004, 5,000 persons would make it possible to estimate this prevalence with an accuracy of approximately 0.22%. All indicators can be analysed according to the characteristics of the participants collected in the Health Barometer questionnaire. Discussion. The BaroTest results will help to inform new strategies for HIV, hepatitis B and C screening and - if the study’s acceptability and feasibility results prove conclusive – will encourage the expansion of the current screening offer to include home self-sampling. BaroTest was linked to a randomised telephone survey, which uses a complex call protocol to increase the likelihood of interviewing hard-to-reach individuals and to achieve a high response rate. The Health Barometer provides a reliable updated assessment of the burden of HBV, HCV and HIV infections in the general population in France, while reducing the costs typically associated with this type of research. Trial registration. BaroTest was approved by the French Ethics Committee (05/11/2015) and the Commission on Information Technology and Liberties (24/12/2015). The study has been registered by the French medical authority under number 2015-A01252-47 on 10/11/2015.
Background: Despite substantial screening for HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) infections in France, a great number of infected persons remain undiagnosed. In this context, Santé publique France experimented with a new screening approach for HBV, HCV, and HIV infection, based on home self-sampling using dried blood spot (DBS) for blood collection.
Objectives:In France cervical cancer screening (CCS) by Pap smear can be performed by general practitioners (GPs), andmedical gynecologists. Medical gynecologists manage contraception, cancer screening, menopause, while deliveries andsurgery remain to obstetricians. Women have direct access to gynecologists as primary care practitioners. Our aim was tomeasure GPs’ involvement in CCS and investigate the characteristics of GPs associated with no practice of CCS. Methods:Data came from 3 cross-sectional surveys conducted among representative samples of French GPs in 1998,2002 and 2009 (n = 6213).We conducted univariate and multivariate logistic regressions stratified on GPs’ sex to investi-gate the characteristics (age, solo or group practice, professional network, area of practice...) of the GPs associated withno practice of CCS ever. Results:The proportion of GPs not performing CCS increased from 24.1% to 34.8% over the period (χ2,p<0.0001). Womenperformed CCS increasingly more than men in all three years, from 8.7% more than men up to 17.1%. In multivariate analy-ses, female GPs with unregulated fees were more likely not to perform CCS (2.31, 95% CI: 1.50-3.56) as were male GPsbelonging to no professional network (1.38, 95% CI: 1.15-1.66). Male GPs from the Paris metropolitan area were less likelyto perform CCS until 2002. Conclusions:Less and less GPs engage in CCS when the growing scarcity of medical gynecologists calls for more partic-ipation. Female GPs remain significantly more active in CCS than male GPs. The participation in CCS is determined differ-ently according to the practitioner’s gender.
Background: Past studies on smokers’ risk perception have produced mixed results. We endorsed a new approach to assess smokers’ perceptions of risk by asking them to estimate threshold values for the cancer risk associated with daily consumption of tobacco and number of smoking years. We expected that many smokers would endorse a “risk denial” attitude, with threshold estimates higher than their own smoking consumption and duration. Methodology: A French national telephone survey (n = 3820; 979 current smokers) included several questions about smoking behaviours and related beliefs. Results: Among current smokers, 44% considered that smoking can cause cancer only for a daily consumption higher than their own consumption, and an additional 20% considered that the cancer risk becomes high only for a smoking duration higher than their own. Most smokers also agreed with other “risk denial” statements (“smoking is not more dangerous than air pollution,” “some people smoke their whole life but never get sick”). Those who considered they smoked too few cigarettes to be at risk were less likely to report personal fear of smoking related cancer. Conclusion: Risk denial is quite widespread among smokers and does not simply reflect a lack of information about health risks related to tobacco. Fully informing smokers about their risks may necessitate changing the way they process information to produce beliefs and limiting their capacity to generate self exempting beliefs.
