Factors associated with influenza vaccination of general medicine interns in Nancy, France, in 2017

  • Cossi Angelo AttinsounonEmail author
  • Clémence Cordonnier
  • Céline Pulcini
  • Paolo Di-Patrizio
  • Nathalie Thilly
  • Thierry May
Original Article


Winter flu is an epidemic infectious disease which sometimes causes serious complications in vulnerable people treated in general practice. Currently, the most effective means of prevention is influenza vaccination, which is recommended for healthcare professionals, including general medicine interns. The target of 75% coverage set by WHO for healthcare professional is rarely reached. Our survey provides an assessment of reported influenza vaccination of general medicine interns (GMI) and evaluates factors influencing their vaccination status. A cross-sectional survey was conducted from 27 September to 2 November 2017 in the Faculty of Medicine at the University of Lorraine in France. An anonymous self-administered questionnaire was distributed electronically (SurveyMonkey software) to all GMI. It collected data on their vaccination status and on levers and barriers to influenza vaccination. The data were analysed using SAS 9.4 software. Multivariate analysis helped identify factors associated with their influenza vaccination status. Of the 595 GMI invited, 269 participated in the survey, with a response rate of 45.2%. During the 2015, 2016, and 2017 winters, overall self-declared vaccine coverage was 37.9, 49.4, and 56.5%, respectively. Being at the end of training (p = 0.008, OR = 3.2), the presence of a mobile vaccination team (p = 0.019, OR = 3.1), and recommending vaccination to one’s relatives and friends (p < 0.0001, OR = 5.4) were the three factors independently associated with influenza vaccination. The two main reasons which had a strong influence on non-vaccination were forgetting to do so (30.5%) and lack of time (24.8%). Influenza vaccination coverage of GMI in Nancy falls well short of WHO targets. Vaccination campaigns and facilitated access to vaccination at study and work placement locations should be considered.


Influenza vaccination General medicine interns Levers and barriers 



Thanks are given to Mrs. Amandine Luc and Mr. Jude Sweeney for their support of this work.

Author contributions

C.A.A initiated the study and C.A.A. and C. C. wrote the protocol, with contributions from all authors. C.C. provided the data; N.T. analysed the data, under the supervision of T. M. and P. D-P. C.A.A., C. C., and C. P. wrote the manuscript, which was reviewed by all co-authors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The survey was completely anonymous at all stages. As no information on respondents’ health was collected, no ethical approval was required for this study.

Informed consent

Participation for this study was voluntary and not compensated.


  1. 1.
    Organisation Mondiale de la Santé (OMS). Grippe saisonnière. Disponible sur: Accessed 18 Aug 2017
  2. 2.
    Rizzo C, Rezza G, Ricciardi W (2018) Strategies in recommending influenza vaccination in Europe and US. Hum Vaccines Immunother 14(3):693–698CrossRefGoogle Scholar
  3. 3.
  4. 4.
    World Health Organization (WHO). Prevention and control of influenza pandemics and annual epidemics. Resolution of the World Health Assembly, 10th Plenary Meeting. Rep. 2003. WHA56.19Google Scholar
  5. 5.
    Burls A, Jordan R, Barton P et al (2006) Vaccinating healthcare workers against influenza to protect the vulnerable - is it a good use of healthcare resources? A systematic review of the evidence and an economic evaluation. Vaccine 24(19):4212–4221CrossRefGoogle Scholar
  6. 6.
    Preaud E, Durand L, Macabeo B, Farkas N, Sloesen B, Palache A et al (2014) Annual public health and economic benefits of seasonal influenza vaccination: a European estimate. BMC Public Health 14(1):813CrossRefGoogle Scholar
  7. 7.
    Giannattasio A, Mariano M, Romano R, Chiatto F, Liguoro I, Borgia G et al (2015) Sustained low influenza vaccination in health care workers after H1N1 pandemic: a cross sectional study in an Italian health care setting for at-risk patients. BMC Infect Dis 15:329CrossRefGoogle Scholar
  8. 8.
    Haviari S, Bénet T, Saadatian-Elahi M, André P, Loulergue P, Vanhems P (2015) Vaccination of healthcare workers: a review. Hum Vaccines Immunother 11(11):2522–2537CrossRefGoogle Scholar
  9. 9.
    Guthmann J-P, Fonteneau L, Ciotti C, Bouvet E, Pellissier G, Lévy-Bruhl D et al (2012) Vaccination coverage of health care personnel working in health care facilities in France: results of a national survey, 2009. Vaccine 30(31):4648–4654CrossRefGoogle Scholar
  10. 10.
    Kernéis S, Jacquet C, Bannay A, May T, Launay O, Verger P et al (2017) Vaccine education of medical students: a nationwide cross-sectional survey. Am J Prev Med 53(3):e97–e104CrossRefGoogle Scholar
  11. 11.
    Loulergue P, Fonteneau L, Armengaud J-B, Momcilovic S, Levy-Brühl D, Launay O et al (2013) Vaccine coverage of healthcare students in hospitals of the Paris region in 2009: the Studyvax Survey. Vaccine 31(26):2835–2838CrossRefGoogle Scholar
  12. 12.
    Mir O, Adam J, Gaillard R, Gregory T, Veyrie N, Yordanov Y et al (2012) Vaccination coverage among medical residents in Paris, France. Clin Microbiol Infect 18(5):e137–e139CrossRefGoogle Scholar
  13. 13.
    Ruta J. La vaccination anti grippale chez les internes de médecine générale. Une étude quantitative à la faculté de médecine de Lille. Thèse Med. Université de Lille 2; 2016; 2016LIL2M303; 40 p. Accessed 18 Aug 2017
  14. 14.
    Perrot C (2014) La vaccination antigrippale des soignants. Enquête auprès des interne en médecine générale de Haute-Normandie. Thèse Med Université de Rouen; 2014ROUEM058; 75 p. Accessed 18 Aug 2017
  15. 15.
    Seringe E, Flahault A, Blanchon T (2005) Vaccination Anti Grippale - Medecins généralistes -Reseau Sentinelles. Accessed 18 Aug 2017
  16. 16.
    Le Maréchal M, Collange F, Fressard L, Peretti-Watel P, Sebbah R, Mikol F et al (2015) Design of a national and regional survey among French general practitioners and method of the first wave of survey dedicated to vaccination. Méd Mal Infect 45(10):403–410CrossRefGoogle Scholar
  17. 17.
    Gehanno J-F (2017) Protection des professionnels de santé contre la grippe: vaccin ou masque? Revue du Praticien - Médecine Générale 67(2):131–133Google Scholar
  18. 18.
    Abu-Gharbieh E, Fahmy S, Rasool BA, Khan S (2010) Influenza vaccination: healthcare workers attitude in three Middle East countries. Int J Med Sci 7(5):319–325CrossRefGoogle Scholar
  19. 19.
    Collange F, Verger P, Launay O, Pulcini C (2016) Knowledge, attitudes, beliefs and behaviors of general practitioners/family physicians toward their own vaccination: a systematic review. Hum Vaccines Immunother 12(5):1282–1292CrossRefGoogle Scholar
  20. 20.
    National Vaccine Advisory Committee (2013) Strategies to achieve the healthy people 2020 annual influenza vaccine coverage goal for health-care personnel: recommendations from the national vaccine advisory committee. Public Health Rep 128(1):7–25CrossRefGoogle Scholar
  21. 21.
    Costantino C, Amodio E, Calamusa G, Vitale F, Mazzucco W (2016) Could university training and a proactive attitude of coworkers be associated with influenza vaccination compliance? A multicentre survey among Italian medical residents. BMC Med Educ 16:38. CrossRefGoogle Scholar
  22. 22.
    Gruben V, Siemieniuk RA, McGeer A (2014) Health care workers, mandatory influenza vaccination policies and the law. CMAJ Can Med Assoc J 186(14):1076–1080CrossRefGoogle Scholar
  23. 23.
    Lorenc T, Marshall D, Wright K, Sutcliffe K, Sowden A (2017) Seasonal influenza vaccination of healthcare workers: systematic review of qualitative evidence. BMC Health Serv Res 7(1):732. CrossRefGoogle Scholar
  24. 24.
    Wang TL, Jing L, Joseph A, Bocchini JA Jr (2017) Mandatory influenza vaccination for all healthcare personnel: a review on justification, implementation and effectiveness. Curr Opin Pediatr 29(5):606–615CrossRefGoogle Scholar
  25. 25.
    Cortes-Penfield N (2014) Mandatory influenza vaccination for health care workers as the new standard of care: a matter of patient safety and nonmaleficent practice. Am J Public Health 104(11):2060–2065CrossRefGoogle Scholar
  26. 26.
    Hakim H, Gaur AH, McCullers JA (2011) Motivating factors for high rates of influenza vaccination among healthcare workers. Vaccine. 29(35):5963–5969CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Cossi Angelo Attinsounon
    • 1
    • 2
    Email author
  • Clémence Cordonnier
    • 3
  • Céline Pulcini
    • 2
    • 4
  • Paolo Di-Patrizio
    • 3
  • Nathalie Thilly
    • 4
    • 5
  • Thierry May
    • 2
    • 4
  1. 1.Faculté de Médecine, CHUD-Borgou, Unité d’Enseignement et de Recherche en Maladies Infectieuses et TropicalesUniversité de ParakouParakouBenin
  2. 2.CHRU-Nancy, Service des Maladies Infectieuses et TropicalesUniversité de LorraineNancyFrance
  3. 3.Département de Médecine GénéraleUniversité de LorraineNancyFrance
  4. 4.APEMACUniversité de LorraineNancyFrance
  5. 5.CHRU-Nancy, Plateforme d’Aide à la Recherche CliniqueUniversité de LorraineNancyFrance

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