PONE-D-21-00741

Factors driving choices between types and brands of influenza vaccines in general practice in Austria, Italy, Spain and the UK

PLOS ONE

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Reviewers' comments:

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Comments to the Author

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Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: This paper presents the descriptive results of a survey conducted among GP's in four European countries on how they promote influenza vaccination in their clinics and how they choose which influenza vaccine to administer to patients. These findings have implications for vaccine effectiveness estimates, as well as offer insight into vaccine selection when multiple influenza vaccine options are available. The statistical methods used are basic, but I believe they are appropriate.

Specific comments below:

Introduction: nicely written

Methods:

- Lines 130-133: The methods do not explain how open-ended responses were analysed and categorised into themes. Please describe what methods were used. Were themes defined a priori?

- It would be interesting to know how the survey questions were developed. Were they derived from previous research or designed specifically for this study? If the latter, was any theoretical framework used in their development?

Discussion:

-The first paragraph is somewhat repetitive at times. For example, lines 291-296 and lines 313-315 present similar information, as well as lines 335-337 and 304-307 . I suggest rewriting the paragraph to make it somewhat more concise.

-Lines 378-380: As you mention, response rates in Italy were quite low (14%). It would be helpful to have some more discussion on how this may have biased results.

Reviewer #2: Review comments for manuscript: Factors driving choices between types and brands of influenza vaccines in general practice in Austria, Italy, Spain, and the UK

As an important component to advancing evaluation of effectiveness of influenza vaccines, Anke L et al conducted a descriptive study to describe the factors that influence the choice in use of influenza vaccine types and brands among general practitioners and risk category vaccinees in four European Countries.

Annually, several influenza vaccines are recommended in Europe. Factors influencing the use of these vaccines are many and can vary by health providers as well as by those getting vaccinated. The authors conducted a study to better understand these factors in 4 European countries. The research question/s proposed by the authors are of public health importance.

Overall, the manuscript is well written. It is easy to read.

Specific comments:

Methods: The research methods are clear and straightforward. However, the inclusion of Spain-Valencia is somewhat confusing given it was not participating in the DRIVE project. The choice of this site requires a stronger rationale (Line 94-98). Or was it convenient?

Information on how the reliability of the survey tool used was assessed would be beneficial to add. Similarly, regarding the online survey tool, information has not been provided on whether participation could occur more than once?

Details on the sample size that was sufficient to answer the study questions are missing.

Results

The results are well presented.

Table 2, lines 145-150: the numbers in parenthesis are not clearly explained and this is somewhat confusing.

Some results are presented as absolute numbers only; other results are presented as absolute numbers (proportions). It is best to be consistent.

A comment on huge difference in the response rates across countries would be useful.

Discussion

The discussion is well written. Limitations and areas for future research are well captured in the manuscript. Is there any bias that could have made the results less reliable?

The manuscript is well written with good scientific and public health applications. The authors have done a good work.

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Reviewer #1: No

Reviewer #2: Yes: Benjamin Kagina

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Factors driving choices between types and brands of influenza vaccines in general practice in Austria, Italy, Spain and the UK

PONE-D-21-00741R1

Dear Dr. Stuurman,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Holly Seale

Academic Editor

PLOS ONE

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