Vaccination coverage and socioeconomic determinants of BCG vaccination in infants under 3 months of age: results from the Elfe cohort, 2011

Background: The mandatory Bacille Calmette-Guérin (BCG) vaccination was replaced in 2007 by a strong recommendation to vaccinate children most at risk of tuberculosis; however, data on vaccination coverage (VC) are insufficient. We estimated VC at approximately two months of age and identified socioeconomic determinants of vaccination. Methods: The French Longitudinal Study from Early Childhood (Elfe) included a random sample of approximately 18,000 children born in 2011, selected at birth from 320 maternity wards in metropolitan France. Data were collected via questionnaire and telephone interview conducted approximately two months after delivery. Vaccination coverage (VC) was estimated in Île-de-France (IDF) and outside IDF, and for different levels of tuberculosis risk, as approximated by the parents’ geographic origin. Poisson regressions were used to examine associations between socioeconomic variables and BCG vaccination status, expressed as prevalence ratios (PR). Results: BCG vaccination coverage was higher in IDF (59.5%) compared to that of at-risk children outside IDF (46.7%) (p < 0.001). Among children with two parents originating from a country with high tuberculosis endemicity, coverage was 80.5% in IDF and 60.4% outside IDF. In the multivariate model, having one or more parents from a country with high tuberculosis endemicity (PR around 1.40) or having consulted a private pediatrician (PR around 1.15) or a maternal and child health center (PR around 1.40) after discharge from the maternity ward were associated with higher vaccination coverage, whereas higher education among the mother was associated with lower vaccination coverage (OR = 0.80). Conclusion: BCG vaccination occurs early after discharge from the maternity ward. Children who first consulted a pediatrician or a PMI doctor are the best vaccinated. Children at higher risk of tuberculosis are likely well identified by doctors and better vaccinated.

Author(s): Guthmann JP, Ragot M, Ben Boutieb M, Bois C, Dufourg MN, Levy Bruhl D

Publishing year: 2016

Pages: 271-80

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