Determinants of physician attitudes towards the new selective measles vaccine mandate in Germany

BMC Public Health

Cornelia Betsch¹  Vera Zylka-Menhorn²  Ole Wichmann³  Julia Neufeind⁴ 

[1] Center for Empirical Research in Economics and Behavioral Sciences (CEREB), University of Erfurt, Erfurt, Germany;Media and Communication Science, University of Erfurt, Erfurt, Germany;Deutsches Ärzteblatt, Cologne, Germany;Immunization Unit, Robert Koch Institute, Berlin, Germany;Immunization Unit, Robert Koch Institute, Berlin, Germany;Charité University Medicine Berlin, Berlin, Germany;

关键词: Vaccine hesitancy;    Measles;    Mandatory vaccination;    Germany;    Health care workers;   

DOI  :  10.1186/s12889-021-10563-9

来源: Springer

【 摘 要 】

BackgroundIn Germany, a mandatory policy on measles vaccination came into effect in March 2020. Physicians, as the main vaccine providers, have a crucial role in implementing it. Mandatory vaccination changes the preconditions under which patient-provider communication on vaccines occurs. Physicians might or might not favor vaccine mandates depending on, among other factors, their attitudes towards vaccines and capabilities as vaccine providers. The aim of this study was to investigate in different subgroups of physicians the association between various factors and their attitudes towards a mandatory policy.MethodsIn total, 2229 physicians participated in a mixed-mode online/paper-pencil survey. Respondents were general practitioners, pediatricians, gynecologists, and internists. Primary determinants were the 5C psychological antecedents of vaccination, communication self-efficacy, patient clientele, projected consequences of the mandate and sociodemographic characteristics. Associations between outcomes and determinants were examined using linear regression analysis.ResultsApproximately 86% of physicians were in favor of the measles vaccine mandate for children. Regarding the 5C model, physicians were more in favor of vaccine mandates when they scored higher on confidence and collective responsibility, and lower on complacency and calculation. They were more in favor of vaccine mandates when they had higher communication self-efficacy and a more vaccine-positive patient clientele. Pediatricians were less in favor of mandates for children (80.0%) than other physician subgroups (87.1%). They were also less convinced that a mandate would result in more children getting vaccinated (59.3%) than other physician subgroups (78.3%). When controlled for these expected consequences, being a pediatrician no longer lowered the attitude towards the mandate.ConclusionsPhysicians in Germany are predominantly in favor of a measles vaccine mandate. Whether or not physicians believe the mandate to be effective in increasing vaccine coverage affects their attitude towards the mandate. In pediatricians, this belief explains their less positive attitude towards the mandate. In addition, physicians need adequate support to communicate well with patients, especially those who are hesitant, to booster their communication self-efficacy. To increase acceptance of vaccine mandates, the 5C model can be used, e.g., collective responsibility can be communicated, to avoid anger stemming from a negative attitude to mandates.

【 授权许可】

CC BY