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Factors influencing BCG immunization since the end of compulsory vaccination in France.L. Rossignol1,2*, J.-P. Guthmann3, S. Kernéis1,2, I. Aubin-Auger4, A. Lasserre1,2, P. Chauvin1,2, C. Pelat1,2, T. Hanslik2,5, D. Lévy-Bruhl3, T. Blanchon1,2.1 UPMC Université Paris 06, UMR S707, F-75012, Paris, France ; 2 INSERM, U707, F-75012, Paris, France; 3 Institut de VeilleSanitaire, F-94415 Saint-Maurice, France; 4 Université Paris Diderot, Paris 7, UFR de Médecine, site Bichat, F-75018, Paris, France; 5 Université Versailles Saint Quentin en Yvelines, F-78000, Versailles, France. [email protected]
In January 2006, the BCG vaccination multipuncture device has been replaced in France by intradermal vaccination. This event occurred when public health authorities were re-assessing the routine mandatory vaccination strategy. In July 2007, compulsory BCG vaccination has been replaced by selective vaccination targeted to children considered at high risk of tuberculosis. However, several health indicators have shown, since those events, a decrease of the immunization coverage among the target population.
How to improve vaccination coverage among children targeted by BCG vaccination?
Factors associated with BCG immunization among eligible children (N=255)
Overall, 358 GPs enrolled 920 children.
In the targeted children’s population, 7 variables were independently associated with the immunization status (table 1).
Eligibility for BCG vaccination
Table 1: Factors associated with BCG immunization among eligible children (N=255) (n(%), mean ± SD)
Of the 920 children included in the study, 261 (31%) were identified to be at risk for tuberculosis (i.e. having at least one of the 6 criteria).
Figure 1 : Proportion of children for each criteria of eligibility
Reasons for not being immunized with BCG vaccine
BCG vaccination coverage
Of the 261 children (31%) identified to be at risk for tuberculosis, only 113 (44 %) were vaccinated. Median age of vaccinated children was 2 months [IQR=1-3 months] and 59% of those were vaccinated by their usual GP. The other vaccination places were mainly maternal and child health clinics or pediatricians.
Figure 2 : Age at BCG vaccination