Hepatitis B virus vaccination by French family physicians

Vaccine coverage against hepatitis B virus (HBV) in France has decreased to one of the lowest levels among countries that recommend it, over the last decade. The probable cause was that the vaccine was suspected to induce demyelinating diseases. We studied the factors limiting the use of HBV vaccine amongst French family physicians (FPs), who play a significant role in the implementation of the vaccination policy.

We conducted a national survey in 2008, using an interactive questionnaire sent by e-mail to 2175 private general practitioners in metropolitan France. This questionnaire provided us with demographic data and information on perception, opinions and practices of FPs regarding HBV vaccination. It also assessed practical barriers to vaccination FPs encountered. The answer structure was analyzed by multiple correspondence analysis (MCA). An agglomerative hierarchical clustering (AHC) identified typical behaviors among FPs. We determined and tested specific links among answers. The representativeness of the final sample (341FPs) was tested.

HBV vaccination for infants is increasingly recommended; children and teenage vaccine catch-up is less routinely recommended; 25% of FPs are opposed to systematic vaccination; the main barrier to vaccination, according to FPs, remains public opinion on the vaccine's potential adverse effects; barriers among physicians include excessive precaution principle in prescribing the vaccine and misconceptions on hepatitis B and vaccination.