BCG Vaccination Coverage in Private Practice: Initial Data on Infants, Seven Months After the Mandatory Vaccination Requirement Was Lifted in France

Objectives - Following the suspension of the mandatory BCG vaccination requirement and its replacement with a strong recommendation for children at risk of tuberculosis, there is a risk that vaccination coverage (VC) will decline among these children. The lack of appropriate tools to identify such a trend early on led us to conduct a survey whose primary objective was to estimate BCG VC in private practice among children born after the requirement was lifted, for whom BCG is recommended. Methods - A cross-sectional survey conducted among physicians subscribed to Infovac-France. Each physician was asked to include between six and 12 children aged 2 to 23 months seen in their practice, regardless of their BCG status. The questionnaire was completed directly online, and the data were analyzed after sample adjustment. Results - A total of 2,536 children recruited by 279 pediatricians and general practitioners (6.5% of the physicians contacted) were included. Vaccination coverage among children meeting the new vaccination recommendations and followed in private practice was 68% overall; it was 77% among those born between the discontinuation of the multi-puncture BCG vaccine and the suspension of the vaccination requirement, and 58% among children born after the suspension of the vaccination requirement (68% in the Île-de-France [IDF] region, 48% outside the IDF region). Among children in IDF born after the mandatory requirement was lifted and considered to be at particularly high risk (presence of a vaccination criterion in addition to residing in IDF), vaccination coverage reached 90% (it was 60% among those with no other criterion besides residing in IDF). Among private practitioners, 75% usually administered the BCG vaccine themselves, and 58% had recommended or offered the vaccine to unvaccinated at-risk children. Seventy-six percent of parents accepted this vaccination when it was offered to them. Conclusion - Our survey suggests, on the one hand, that vaccination coverage remains insufficient among children seen in private practice who were born after the suspension of mandatory vaccination; on the other hand, it provides encouraging findings: good vaccination coverage among high-risk children in the Paris region and high acceptance of the new vaccination policy by both physicians and families. These results, although they must be interpreted with caution (sample of physicians subscribed to Infovac and methodological limitations), support the need to strengthen communication regarding the new vaccination policy. (R.A.)

Author(s): Guthmann JP, de La Roque F, Boucherat M, van Cauteren D, Fonteneau L, Lecuyer A, Cohen R, Levy Bruhl D

Publishing year: 2009

Pages: 489-95

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