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Wang Q, Nacher M, Tosi A, Clarke L, Rwagitinywa J, Alsibai KD, Castor MJ. Coverage of BCG Vaccination for children aged until 7 years old and its determinants in French Guiana. JOURNAL OF EPIDEMIOLOGY AND POPULATION HEALTH 2024; 72:202381. [PMID: 38579396 DOI: 10.1016/j.jeph.2024.202381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 04/07/2024]
Abstract
INTRODUCTION The overall incidence of tuberculosis (TB) in France is low; thus, BCG vaccination is no longer mandatory. In French Guiana - a French overseas territory - BCG vaccination is strongly recommended because the incidence of TB is high in the context of mass immigration from endemic countries with low BCG vaccination rates. Thus, it is important to assess Bacillus Calmette-Guérin (BCG) vaccination coverage and its predictors. METHODS We used data from the 2014 French Guiana Yellow Fever survey, which was conducted by the Observatoire Régional de la Santé de Guyane. Demographic and immunization data from eligible children and their families were collected using a questionnaire. Children who had an immunization card and who were no older than 7 years of age at the time of the survey were eligible. The Coverage for BCG and other mandatory vaccines were estimated; the delay in BCG vaccination was also computed. Univariate and multivariate analyses identified predictors associated with BCG immunization and BCG delayed immunization (after 2 months of age). RESULTS AND CONCLUSION Overall, 469 children were eligible for this study. The total BCG coverage was 79.5 %, and the proportion of children vaccinated with delay was 50.7 %. The multivariate analysis indicated that BCVA was significantly greater among children younger than 3 years of age, whose household head was employed and whose education level was greater. None of the predictors were associated with the delay of BCG vaccination.
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Affiliation(s)
- Qiannan Wang
- Registre des Cancers de Guyane, Cayenne 97300, French Guiana; Amazonian Infrastructures for Population Health, Cayenne 97300, French Guiana; Département Recherche Innovation Santé Publique, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana.
| | - Mathieu Nacher
- Registre des Cancers de Guyane, Cayenne 97300, French Guiana; Amazonian Infrastructures for Population Health, Cayenne 97300, French Guiana; CIC INSERM 1424, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana; Département Formation Recherche Santé, Université de Guyane, Cayenne 97300, French Guiana
| | - Alice Tosi
- Amazonian Infrastructures for Population Health, Cayenne 97300, French Guiana; Département Recherche Innovation Santé Publique, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana; Registre des handicaps de l'enfant et observatoire périnatal de Guyane, Cayenne 97300, French Guiana
| | - Loreinzia Clarke
- Observatoire Régional de la Santé de Guyane, Cayenne 97300, French Guiana
| | - Joseph Rwagitinywa
- Observatoire Régional de la Santé de Guyane, Cayenne 97300, French Guiana
| | - Kinan Drak Alsibai
- Registre des Cancers de Guyane, Cayenne 97300, French Guiana; Département Recherche Innovation Santé Publique, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana; Centre de Ressources Biologiques Amazonie, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana; Service d'Anatomopathologie, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana
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Jacques M, Lorton F, Dufourg MN, Bois C, Launay E, Siméon T, Raude J, Guen CGL, Lévy-Brühl D, Charles MA, Chalumeau M, Scherdel P. Determinants of incomplete vaccination in children at age two in France: results from the nationwide ELFE birth cohort. Eur J Pediatr 2023; 182:1019-1028. [PMID: 36542162 PMCID: PMC9768772 DOI: 10.1007/s00431-022-04733-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022]
Abstract
Incomplete vaccination in the pediatric population is a growing public health issue in high-income countries, but its determinants are poorly understood. Their identification is necessary to design target actions that can improve vaccination uptake. Our aim was to assess the determinants of incomplete vaccination in two-year-old children in France. Among the 18,329 children included in the 2011 ELFE French nationwide population-based birth cohort, we selected those for whom vaccination status was available at age two years. Incomplete vaccination was defined as ≥ 1 missing dose of recommended vaccines. Potential determinants of incomplete vaccination were identified by using logistic regression, taking into account attrition and missing data. Of the 5,740 (31.3%) children analyzed, 46.5% (95% confidence interval [CI] 44.7-48.0) were incompletely vaccinated. Factors independently associated with incomplete vaccination were having older siblings (adjusted odds ratio 1.18, 95% CI [1.03-1.34] and 1.28 [1.06-1.54] for one and ≥ 2 siblings, respectively, vs. 0), residing in an isolated area (1.92 [1.36-2.75] vs. an urban area), parents not following health recommendations or using alternative medicines (1.81 [1.41-2.34] and 1.23 [1.04-1.46], respectively, vs. parents confident in institutions and following heath recommendations), not being visited by a maternal and child protection service nurse during the child's first two months (1.19 [1.03-1.38] vs. ≥ 1 visit), and being followed by a general practitioner (2.87 [2.52-3.26] vs. a pediatrician). CONCLUSIONS Incomplete vaccination was highly prevalent in the studied pediatric population and was associated with several socio-demographic, parental, and healthcare service characteristics. These findings may help in designing targeted corrective actions. WHAT IS KNOWN • Incomplete vaccination in the pediatric population is a growing public health issue in high-income countries. • The partial understanding of the determinants of incomplete vaccination precludes the design of effective targeted corrective actions. WHAT IS NEW • High prevalence of incomplete vaccination at age two years in France. • Incomplete vaccination was independently associated with several socio-demographic, parental, and healthcare service characteristics.
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Affiliation(s)
- Marianne Jacques
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
| | - Fleur Lorton
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
- grid.277151.70000 0004 0472 0371Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| | - Marie-Noëlle Dufourg
- grid.7429.80000000121866389French Institute for Demographic Studies (Ined), Inserm, French Blood Agency, ELFE Joint Unit, Aubervilliers, France
| | - Corinne Bois
- grid.7429.80000000121866389French Institute for Demographic Studies (Ined), Inserm, French Blood Agency, ELFE Joint Unit, Aubervilliers, France
| | - Elise Launay
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
- grid.277151.70000 0004 0472 0371Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| | - Thierry Siméon
- grid.7429.80000000121866389French Institute for Demographic Studies (Ined), Inserm, French Blood Agency, ELFE Joint Unit, Aubervilliers, France
| | - Jocelyn Raude
- grid.414412.60000 0001 1943 5037EHESP-School of Public Health, Rennes, France
| | - Christèle Gras-Le Guen
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
- grid.277151.70000 0004 0472 0371Department of Pediatric Emergency Care, Nantes University Hospital, Nantes, France
| | - Daniel Lévy-Brühl
- grid.493975.50000 0004 5948 8741Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Marie-Aline Charles
- grid.7429.80000000121866389French Institute for Demographic Studies (Ined), Inserm, French Blood Agency, ELFE Joint Unit, Aubervilliers, France
| | - Martin Chalumeau
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.508487.60000 0004 7885 7602Department of General Pediatrics and Pediatric Infectious Diseases, AP-HP, Necker-Enfants malades hospital, Université Paris Cité, Paris, France
| | - Pauline Scherdel
- Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé), Université Paris Cité, Inserm, Center for Research in Epidemiology and StatisticS (CRESS), 75004 Paris, France
- grid.277151.70000 0004 0472 0371Inserm 1413 CIC FEA, Nantes University Hospital, Nantes, France
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