Background and Objectives

Conducted door-to-door across the entire island by Red Cross surveyors, this survey aimed to gather essential information to improve understanding and enable the adaptation of the regional vaccination strategy:

• Assessment of vaccination coverage rates for the 11 mandatory vaccinations for children born on or after January 1, 2018

• Assessment of vaccination coverage and booster doses for 7- to 8-year-olds, adolescents, and young adults

• Comparison of these coverage rates with those measured in the 2009 Regional Health Observatory (ORS) study.

Key findings

Since January 1, 2018, 11 vaccines have been mandatory for children under 2 years of age. The survey conducted in 2022 shows that:

• This vaccination requirement is met for 6 vaccines (DTP (Diphtheria-Tetanus-Polio), pertussis, Hib (Haemophilus influenzae type b), and hepatitis B)

  • 9 out of 10 children have a complete vaccination schedule

• However, further efforts are needed for the other 5 vaccines (MMR (Measles-Mumps-Rubella), meningococcal type C, and pneumococcal).

  • For pneumococcal vaccine, the 95% target has not been met, with a full vaccination coverage rate of 86.8%

  • For the Measles, Mumps, and Rubella (MMR) vaccine, 8 out of 10 children have completed the 2-dose vaccination schedule. This rate is insufficient to protect us from the risk of a measles epidemic.

  • For meningococcal type C vaccination, fewer than 6 out of 10 children have completed the vaccination series.

In light of the resurgence of measles cases observed in France and Europe, the full two-dose vaccination regimen is the only preventive measure capable of effectively protecting the population and thus preventing an epidemic. Reunion Island has an insufficient vaccination coverage rate estimated at 82%, while the target is 95%. The goal of widespread measles vaccination is to eliminate the disease.

• Vaccination coverage for DTP remains insufficient among children aged 7 to 8

  • Only 77.8% of children have completed the vaccination series

• For young adults (ages 19–28), insufficient vaccination coverage is observed for DTP and pertussis, due to missed booster shots

  • 74.3% coverage for DTP

  • 36.7% coverage for pertussis

Conclusions

Conducting this survey allowed for an update of vaccination coverage data in Réunion and also helped identify trends compared to the results of the survey conducted by the ORS in 2009.
It also highlighted generally positive results regarding the mandatory vaccination schedule for the 11 vaccines for children born since January 1, 2018, particularly for children aged 24 to 59 months.
However, regarding measles, vaccination coverage among children (using the two-dose MMR vaccine) falls short of the national target and may expose us to the risk of an epidemic.

Regarding pertussis, in a national and European context of a resurgence at a high intensity level, the health situation in Réunion, despite an increase in reports to the ARS, remains moderate compared to mainland France.
The pertussis vaccination policy in France aims to reduce severe cases, hospitalizations, and deaths related to pertussis, which occur primarily among infants under 6 months of age.

It is based on three complementary strategies:

• Vaccination is mandatory for infants born on or after January 1, 2018, at 2 months and 4 months of age, with booster doses at 11 months, 6 years, and 11–13 years, continuing through adulthood (up to age 25, with the option to catch up until age 39).

• Vaccination is strongly recommended for pregnant women, starting in the second trimester of pregnancy, with a preference for the period between 20 and 36 weeks of amenorrhea.

• If the mother was not vaccinated during pregnancy, vaccination of the mother postpartum and of individuals likely to be in close contact with the infant during the first 6 months of life is recommended (a strategy known as “cocooning”).

The results of this survey highlight the need to:

• To inform and promote mandatory vaccination to eradicate the 11 contagious diseases through public awareness campaigns targeting the public (parents) and healthcare professionals,

• to offer targeted catch-up vaccination campaigns when coverage is deemed insufficient, in light of national recommendations and the regional context.

The concrete actions proposed by the ARS of Réunion will be as follows:

• To inform and promote mandatory vaccination to eradicate the 11 contagious diseases through awareness campaigns targeting the public (parents), the national education system, and healthcare professionals,

• to propose targeted catch-up vaccination campaigns when coverage is deemed insufficient, in light of national recommendations and the regional context:

  • Working and consultation meetings with healthcare professionals (private practitioners, pediatricians, in collaboration with the PMI, school health services in coordination with the regional education office): review of the vaccination schedule and proposal to conduct a catch-up vaccination campaign for infants, young children, and adolescents: a webinar is scheduled for October 29 with the CPTS: a reminder regarding raising awareness among healthcare professionals about this catch-up vaccination campaign will be provided.

• Proposal for a vaccination booster campaign in conjunction with the rollout of the HPV vaccination campaign in schools for 7th-grade students,

• Proposal to launch a catch-up vaccination campaign (e.g., DTP and pertussis boosters) among students (targeting young adults), in collaboration with university preventive medicine,

• Proposal, in conjunction with the rollout of the “prima facie” program in pre- and postnatal care, to remind expectant mothers of the importance of vaccination (particularly against pertussis) starting in the second trimester of pregnancy, with a focus on the period between 20 and 36 weeks of amenorrhea, and the vaccination of the mother postpartum and of individuals likely to be in close contact with the infant during its first 6 months of life.