Motivators and Barriers of Primary Healthcare to Vaccines not included in National Immunization Schedule

Background and Objectives: Vaccination has made an enormous contribution to the population growth and mortality rate decrease. The Portuguese National Vaccination Program includes 8 vaccines against 12 target diseases. Although some vaccines are not yet present in the program, they are considered safe and effective. The aim of this study was to evaluate opinion amongst primary healthcare workers about vaccines not included in the National Immunization Schedule (NIS).

Methods: An observational and descriptive study using a questionnaire to primary health care professionals about vaccines not include in NIS. The study had two phases (2017 and 2018), separated with clinical sessions and pamphlets distribution.

Results: 58 health professionals participated in the survey in 2017, of which 66% were nurses and 34% doctors. In the second questionnaire (2018), 83 health professionals were interviewed (53% nurses and 47% doctors). An average of 12 and 15 years of professional activity was observed in 2017 and 2018, respectively. Of the study participants, 54 (91%) in 2017 and 82 (97.6%) in 2018 addressed the topic in primary health care appointment. The most recommended vaccines were against rotavirus and Neisseria meningitidis B. Approximately 19% in 2017 refer that they did not feel comfortable discussing these issues with parents, a value that decreases to 2.4% after clinical sessions. The main reasons for the lack of initiative to recommend were monetary value and lack of knowledge. Considering the professional category, it was observed a difference in the recommendation of rotavirus (p-value 0.004), hepatitis A (p-value 0.036) and human papillomavirus virus (p-value 0.035) vaccines in 2017 questionnaire. Most participants agreed with human papillomavirus virus in the male genre, but only 22.4% and 51.2% recommend it.

Conclusion: This study allows to recognize motivators and barriers that are important for identifying intervention points for improving the approach of this topic with parents.