Vaccination coverage among children and adolescents below 18 years of age in French Guiana: inventory and determinant factors

OBJECTIVE

The purpose of this study was to estimate the vaccination coverage (VC) rate in persons aged from 9 months to 18 years and to describe it according to the predictive factors of good vaccination status.

STUDY DESIGN

Descriptive and etiological study.

METHODS

The study involved 1332 persons aged below 18 years and members of 521 representative households in French Guiana. VC was estimated by the proportion of people with complete immunization for 13 vaccines (four mandatory, seven recommended, and two specific). This vaccination status was described in terms of sociodemographic characteristics. The relationship between vaccination status and predictive factors was analyzed in a hierarchical mixed, polytomic, and ordered regression model.

RESULTS

For compulsory vaccination, VC was 81.2% for yellow fever, 63.4% for diphtheria, 61.7% for tetanus, and 61.6% for poliomyelitis. The proportion of people with complete immunization for recommended vaccines remains well below 50% (11.7% for pneumococcus and 6.2% for meningitis). Regardless of the vaccine, respondents aged 3-7 years were 2.5 times more likely to have an up-to-date vaccination compared to respondents younger than 3 years of age (P < 0.001).

CONCLUSION

The VC observed in this study is still below the departmental objectives. The link between age and vaccination status could be explained by the efforts of the national education authorities to systematically check health cards for preschool and school enrollment.

[On the moral dutifulness of using vaccinations]

People had contradictory opinions on using vaccinations over time: an initial opposition, later large favour and then doubts and perplexities. In recent times, some movements, blogs and associations stigmatize the use of vaccinations and they are increasingly asking to remove mandatory vaccinations in countries where they are active. The impact of the antivaccination campaigns should not be underestimated, considering that, for example, in Italy, due to these campaigns, adhesions to vaccinations are decreasing by 1% per year, and in reference to rubella and measles, adhesions decreased by 25% in some regions of the country. Overcoming the choice between mandatory and recommended vaccinations, the paper deals with the topic of using preventive immunization starting from the concept of "moral dutifulness".