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[Vaccination calendar and new risks of infection]
1Service de Pédiatrie et de Pathologie Infectieuse, Hôpital Armand-Trousseau, Paris.
Insights
France
Area of Science:
- Public Health
- Vaccinology
- Epidemiology
Context:
- France's immunization program has evolved significantly since the 1990s.
- Resurgence of pertussis in adults and infants highlights immunity gaps.
- Measles, mumps, rubella, and hepatitis B vaccination coverage present challenges.
Purpose:
- To review changes in the French immunization program.
- To address challenges in vaccine coverage and disease resurgence.
- To inform strategies for improving public health through vaccination.
Summary:
- New pertussis boosters and a second measles-mumps-rubella (MMR) vaccine dose are recommended.
- Coverage rates for hepatitis B vaccination vary significantly between infants and adolescents.
- Mathematical modeling indicates a risk of large-scale epidemics for several vaccine-preventable diseases.
Impact:
- Enhanced vaccination strategies are crucial to prevent disease outbreaks.
- Achieving higher vaccination coverage is essential for herd immunity.
- Continued monitoring and adaptation of immunization programs are necessary to protect public health.
Abstract:
The French program for immunization has undergone great changes since the last 90', with new vaccines and strategy improvement. The resurgence of pertussis in young adults with transmission to young infants not adequately immunized is due to the lack of immunity and reduced potential to acquire exposure-induced immunity. A late booster is recommended at 11 years by the new acellular pertussis vaccine (combined with DT I.P.V. Vaccines). The coverage rate for measles-mumps-rubella vaccine has reached 82% for 2 year old infants, but the stability for many years has left many susceptible children (not immunized or not seroconverted). A recent mathematical study shows a next risk for large epidemics in older children, adolescents and adults. Rubella has the same development with a recent rise of rubella in pregnant women. The recent recommendation of Health authorities of giving a second dose of measles-mumps-rubella vaccine at 4-6 years is associated to necessary enhancement coverage in 2 year-old infants to 95%. Universal immunization against hepatitis B has been promoted in 1994 for infants and adolescents. The decision is related to the growing number of new hepatitis B infections in spite of a well conducted risk-subject immunization. The 1997 coverage is better for adolescents (78%) than for infants (36%).