Setting priorities for new vaccination programs by using public health officers and immunization managers opinions.

The objective of this work was to assess the opinions of public health professionals (PHPs) about routinely recommended and new vaccines, and to evaluate the feasibility of using a modified Basic Priority Rating System (BPRS) approach to prioritize new immunization programs. One hundred and thirty six PHPs were invited to participate in the survey and 101 responded. Ninty-eight percent of respondents agreed that "recommended vaccines are very useful" (mean score=9.5 out of 10). Between 47% and 100% of respondents agreed with statements about usefulness, safety, effectiveness and acceptability of seven new vaccines (mean scores 5.7-9.7). The highest BPRS scores were observed for MMRV (7.3), DTaP-IPV-HBV-Hib (7.0), and conjugate ACYW-135 (5.4), followed by HPV (4.8), HAV (4.4), rotavirus (1.6) and zoster vaccine (1.5%). The results demonstrate that PHPs perceive presently recommended vaccines as very useful tools in infection prevention. On the other hand, the perceived usefulness, safety, effectiveness, and acceptability of new vaccines are heterogeneous. This heterogeneity is indicative of the complexity of decision-making around implementation of new immunization programs and the need for tools facilitating program prioritization. The modified BPRS approach using survey responses to five statements on program usefulness, vaccine safety, effectiveness, and acceptance by vaccinators and the population is a simple, feasible and inexpensive method of prioritizing new immunization programs. The method we propose is flexible in choosing target groups and allows a large number of professionals to be involved in the decision-making process about new immunization programs.

Vaccination against human papillomavirus: a baseline survey of Canadian clinicians' knowledge, attitudes and beliefs.

We assessed Canadian obstetrician/gynaecologists', family physicians' and paediatricians' knowledge, attitudes, and beliefs about HPV infection and prevention, as well as factors associated with willingness to prescribe HPV vaccines. A self-administered, anonymous questionnaire was mailed to 2500 physicians. The participation rate was 51%. Overall, 95% of respondents indicated that the vaccine should be given to girls before the onset of sexual activity; 80% of respondents felt that the best age for an HPV vaccination program is <14 years; 88% of respondents intend to recommend HPV vaccines if they are publicly funded. Several predisposing, reinforcing, organizational, preventive activity and situational factors were independently associated with the intention to prescribe the HPV vaccines. Most physicians expect an important benefit from HPV vaccination and intend to prescribe HPV vaccines (86.7%). To achieve high rates of vaccination coverage, several modifiable factors should be taken in consideration during immunization program implementation.