According to the French public health regulations, the French Institute for public health surveillance (Institut de veille sanitaire, InVS) is in charge of the follow-up and assessment of immunization coverage for all vaccinations included in the immunization schedule and in all target groups. In this work, we performed an analysis of the different sources of data that can be used to measure coverage in France, and compiled the most recent national and regional data for the different vaccines recommended in different age groups. Until the age of 15, coverage estimates are based on children health certificates and on routine school surveys. In adults, the lack of a routine data collection system explains the absence of estimates in this group and underlines the need for implementing new tools. The analysis of vaccine reimbursement data from a health insurance database ("Echantillon généraliste des beneficiaries", EGB) allows a rapid estimate of immunization coverage after changes to the vaccination schedule. District ("départements") and regional coverage estimates are based on children health certificates; however the analysis of the data provided by the comprehensive social health insurance database (DCIR) should enable a better and deeper subnational analysis. The immunization coverage targets (at least 95% for all vaccinations, except for influenza: 75%) are not met for most vaccinations for which coverage data are available. These data allow classifying the recommended vaccinations in four main groups: vaccinations for which immunization coverage is high and public health goals met (diphtheria, tetanus, polio, pertussis and haemophilus infuenzae b in children); vaccinations for which immunization coverage is insufficient and stable (HPV in female adolescents, pertussis booster in adolescents, first dose of MMR, decennial DTP boosters in adults; BCG in high risk children); vaccinations for which immunization coverage is insufficient and decrease (seasonal influenza); finally, vaccinations for which coverage is insufficient but increasing (second dose of MMR, hepatitis B, meningococcus C, pneumococcal conjugate vaccine). (R.A.)
Auteur : Guthmann JP, Fonteneau L, Levy Bruhl D
Année de publication : 2013
Pages : 4 p.