Vaccine
Volume 33, Issue 7, Pages 833-942 (11 February 2015)
http://www.sciencedirect.com/science/journal/0264410X/33/7

Visualizing knowledge and attitude factors related to influenza vaccination of physicians
Original Research Article
Pages 885-891
Ane Antón-Ladislao, Susana García-Gutiérrez, Núria Soldevila, Fernando González-Candelas, Pere Godoy, Jesús Castilla, José María Mayoral, Jenaro Astray, Vicente Martín, Sonia Tamames, Diana Toledo, Urko Aguirre, Angela Domínguez, the CIBERESP Working Group for the Survey on Influenza Vaccination in Primary Health Care Workers
Abstract
Purpose
To characterize groups of primary healthcare physicians according to sociodemographic data, years of professional experience and knowledge of and attitudes to influenza, and to evaluate differences between groups with respect to influenza vaccination in the 2011–2012 season.
Methods
We carried out an anonymous web survey of Spanish primary healthcare physicians in 2012. Information on vaccination, and knowledge of and attitudes to influenza was collected. Multiple correspondence analysis and cluster analysis were used to define groups of physicians.
Results
We included 835 physicians and identified three types. Type B were physicians with low professional experience of influenza. Types A and C were physicians with high professional experience with influenza, type A also had a high awareness of influenza and seasonal vaccination. Types A and C were older and more often male than type B (p < 0.0001). Knowledge of influenza was greatest in type A and lowest in type B. Awareness of influenza was greatest in type A and lowest in type C. In type A, 71.0% of physicians were vaccinated in the 2011–2012 season, compared with 48.1% and 33.6% from types B and C, respectively (p < 0.001).
Conclusions
Additional efforts should be made to increase interest and concerns about preventing the transmission of influenza in physicians who do not believe influenza is a severe disease and are not concerned about its transmission.

Evaluation of invalid vaccine doses in 31 countries of the WHO African Region
Original Research Article
Pages 892-901
Manas K. Akmatov, Elizabeth Kimani-Murage, Frank Pessler, Carlos A. Guzman, Gérard Krause, Lothar Kreienbrock, Rafael T. Mikolajczyk
Abstract
We examined (a) the fraction of and extent to which vaccinations were administered earlier than recommended (age-invalid) or with too short intervals between vaccine doses (interval-invalid) in countries of the World Health Organisation (WHO) African Region and (b) individual- and community-level factors associated with invalid vaccinations using multilevel techniques. Data from the Demographic and Health Surveys conducted in the last 10 years in 31 countries were used. Information about childhood vaccinations was based on vaccination records (n = 134,442). Invalid vaccinations (diphtheria, tetanus, pertussis [DTP1, DTP3] and measles-containing vaccine (MCV)) were defined using the WHO criteria. The median percentages of invalid DTP1, DTP3 and MCV vaccinations across all countries were 12.1% (interquartile range, 9.4–15.2%), 5.7% (5.0–7.6%), and 15.5% (10.0–18.1%), respectively. Of the invalid DTP1 vaccinations, 7.4% and 5.5% were administered at child’s age of less than one and two weeks, respectively. In 12 countries, the proportion of invalid DTP3 vaccinations administered with an interval of less than two weeks before the preceding dose varied between 30% and 50%. In 13 countries, the proportion of MCV doses administered at child’s age of less than six months varied between 20% and 45%. Community-level variables explained part of the variation in invalid vaccinations. Invalid vaccinations are common in African countries. Timing of childhood vaccinations should be improved to ensure an optimal protection against vaccine-preventable infections and to avoid unnecessary wastage in these economically deprived countries.

Reducing the loss of vaccines from accidental freezing in the cold chain: The experience of continuous temperature monitoring in Tunisia
Original Research Article
Pages 902-907
John Lloyd, Patrick Lydon, Ramzi Ouhichi, Michel Zaffran
Abstract

Optimizing energy for a ‘green’ vaccine supply chain
Original Research Article
Pages 908-913
John Lloyd, Steve McCarney, Ramzi Ouhichi, Patrick Lydon, Michel Zaffran
Abstract
Highlights
:: High energy efficiency in storing and delivering vaccines reduced the recurrent costs of distribution.
:: Adopting a system of planned vaccine deliveries by dedicated electric vehicle was more reliable and timely.
:: Solar modules on the roofs of stores linked to the electrical grid, generate enough ‘green’ energy for storage and transport.
:: ‘Green’ distribution systems for vaccines and medicines meet an increasing need for cooling in public health programmes.