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Barriers to implementation of the new targeted BCG vaccination in France: a cross sectional study

L Rossignol1, J-P Guthmann, S Kernéis

  • 1Département de Médecine Générale, UPMC Univ Paris 06, 27 rue de Chaligny, 75571 Paris cedex 12, France. rossignol@u707.jussieu.fr

Vaccine
|May 26, 2011
PubMed

Insights

BCG vaccination rates declined after mandatory policies ended in France. Factors like child

Area of Science:

  • Public Health
  • Epidemiology
  • Vaccinology

Background:

  • France ended universal and mandatory Bacillus Calmette-Guérin (BCG) vaccination, necessitating an assessment of vaccination influences.
  • Tuberculosis (TB) risk remains a concern, particularly for specific pediatric populations.
  • Understanding factors affecting BCG uptake is crucial for maintaining public health.

Purpose of the Study:

  • To evaluate factors impacting BCG vaccination coverage among children at risk for tuberculosis in France.
  • To identify general practitioner (GP) knowledge and perceptions related to BCG vaccination guidelines.

Main Methods:

  • A 2009 cross-sectional study involving 358 general practitioners (GPs) from the French Sentinel Network.
  • Inclusion of 920 children, with analysis of vaccination status for 261 identified as high-risk for TB.
  • Statistical analysis using an alternating logistic model to identify associated variables.

Main Results:

  • Only 44% of at-risk children (113/261) received BCG vaccination.
  • Key factors increasing vaccination probability included: older age (>6 months), residence in Paris/suburbs, planned travel to endemic areas, unfavorable living conditions, GP knowledge of guidelines, and perception of TB as common.
  • GPs with infectious disease training showed lower adherence to vaccination guidelines (OR=0.14).

Conclusions:

  • BCG vaccination coverage among at-risk children in France is suboptimal.
  • Targeted interventions addressing identified factors can improve BCG immunization rates.
  • Further investigation into the reluctance of GPs with specialized training is warranted.

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