Attitudes of nurses toward current and proposed vaccines for public programs: a questionnaire survey.

摘要

BACKGROUND: In most countries registered nurses play a key role in vaccination. The number of recommended childhood vaccines has increased and several other new vaccines are in the implementation phase or are being considered for public programs. Little is known about nurses' perceived usefulness of recommended vaccines and no recent study has assessed nurses' opinions regarding new candidate vaccines for the public programs. OBJECTIVES: The main purpose of this survey was to assess nurses' opinions regarding already recommended and new candidate vaccines for public programs; based on nurses responses, to assess the perceived priority of implementation of new vaccination programs, and to determine factors associated with the intention to recommend a new vaccine. DESIGN: Cross-sectional survey. SETTING AND PARTICIPANTS: The survey was conducted in June-July 2008 with registered nurses (N=299) randomly sampled from the Quebec Order of Nurses registry. RESULTS: The great majority (97.8%) of nurses somewhat or strongly agreed that the vaccines recommended by public health authorities are very useful. The proportion of nurses that perceived different recommended vaccines as useful varied from 80% to 99%. A high heterogeneity was observed among nurses' opinions regarding the safety and efficacy profile of different new vaccines. From 35% to 69% of nurses self-estimated the information they received on new vaccines as sufficient for their needs. The priority rating of new vaccines was as follows: (1) combined hepatitis A and B vaccine; (2) measles mumps rubella and varicella vaccine; (3) hexavalent diphtheria-tetanus-pertussis based vaccine; (4) pneumococcal 10-valent vaccine; (5) meningococcal ACYW-135 vaccine; (6) human papillomavirus vaccine and (7) Rotaviral vaccine. The willingness to recommend a new vaccine was consistently associated with the perceived vaccine safety, usefulness of a potential immunization program and the perceived professional support of a new vaccine. CONCLUSION: The general attitudes of nurses toward vaccines recommended by public health authorities are positive and were not negatively affected by the recent implementation of the pneumococcal, varicella and influenza vaccines in the childhood vaccination program. Important differences are observed when comparing the perceived usefulness, safety, efficacy, acceptability, and intention to recommend new vaccines. Nurses clearly give their priority to combined vaccines and to vaccines they had received more information about. The delivery of clear evidence-based information about the new immunization program targets and vaccine safety, as well as professional support fostering would increase nurses' willingness to recommend new vaccines.