Déterminants de l'attitude vaccinale contre le zona des médecins généralistes chez les patients de plus de 65 ans en France

Background: Herpes zoster is a common disease among older population, which can cause severe complications. Since 2016, it has been recommended to vaccinate against it for French people aged 65 to 74; nevertheless, vaccine coverage remains very low in France (<5%). Health prevention is performed by primary care providers, which is why it was necessary to analyse general practitioners’ reasons to vaccinate the senior population or not. Methods: A survey about zoster vaccine determinants was sent to 940 French general practitioners. Univariate and multivariate analysis were performed, both aiming to compare these determinants between physicians who do or do not recommend the vaccine. Results: 24.8% of general practitioners recommend the vaccine. 50.9% don’t fully understand the disease’s complications (especially the risk of an acute cardiovascular event following an episode of zoster), but this is not a significant barrier to vaccination. According to the multivariate analysis, the most important barrier to vaccination is the vaccine’s perceived lack of efficiency at reducing the incidence of zoster (p=0.028). The major argument in favour of vaccination is the perception that the quality of life of elderly people is severely reduced by zoster (p=0.017). Conclusion: The lack of knowledge about zoster does not appear to be a barrier to vaccination, but the lack of perception of vaccine’s efficiency is. On the other hand, the negative impact of zoster on one’s quality of life is a motor for vaccination. In order to improve vaccine coverage, it seems general practitioners’ training is highly necessary and should encompass a demonstration of zoster’s complications and of the vaccine’s efficiency.Le zona est une pathologie fréquente chez la personne âgée, induisant des complications sévères. Sa prévention à l’aide d’un vaccin est recommandée pour les patients de 65 à 74 ans depuis 2016 ; cependant la couverture vaccinale en France reste très faible (