Vaccination of Young Children: Data to Better Understand Public Policy
In conjunction with the parliamentary debate on expanding mandatory vaccination requirements for children under two years of age, Santé publique France has published an educational report and a weekly epidemiological bulletin outlining the most up-to-date information on vaccination in France. It presents the results of studies that informed the public consultation on vaccination and the epidemiological arguments demonstrating the importance of improving vaccination coverage among young children. This BEH also gives a voice to general practitioners and future healthcare professionals through the perspectives of the College of General Medicine and residents in public health and general medicine.
Two questions for Dr. Daniel Lévy-Bruhl, an epidemiologist and head of the unit responsible for respiratory infections and vaccination at Santé publique France
What is the current epidemiological situation in France regarding infant vaccinations? In France, vaccination coverage rates for infants are very high for mandatory vaccines or those administered concurrently during the first year of life. However, they are insufficient for vaccines that are only recommended and administered during the second year of life. Our analysis shows how important it is to maintain the very high vaccination coverage rates achieved for the former and to improve them for the latter.
Why is very high infant vaccination coverage necessary? Because there are still diseases in France that could have been eliminated but have not been due to a lack of sufficiently high vaccination coverage. These include, in particular, measles and, to a lesser extent, rubella. We can also add invasive meningococcal C infections in children, which have resulted in nearly 800 cases and 100 deaths since 2011, whereas European countries that have achieved very high coverage levels have virtually eliminated these infections.
There are also diseases that cannot be eliminated due to the limitations of current vaccines. This applies to pertussis and invasive pneumococcal infections. For these conditions, the continued circulation of pathogens justifies the need for the highest possible vaccination coverage, in order to reduce the residual burden of the disease as much as possible.
Three questions for Dr. Christine Jestin, public health physician and head of the Infectious Risk Prevention Unit at Santé publique France
How are vaccines perceived by the public today? The results of our survey show that three out of four people in France say they are generally in favor of vaccination. This overall support for vaccination has increased significantly compared to 2010 (61.2%) but has decreased compared to 2014 (78.8%). It therefore remains high overall.
Does support for vaccination vary depending on the vaccine? Yes, first, vaccination against seasonal influenza garners the most negative opinions (15.4%), followed by vaccination against hepatitis B (13.0%) and vaccination against human papillomavirus (HPV) infections (5.8%).
We observe that vaccines for infants elicit little or no reluctance. For example, vaccination against measles, mumps, and rubella (MMR vaccine), BCG, and vaccination against diphtheria, tetanus, and polio (DTP) elicit less than 2% of unfavorable opinions. Nevertheless, we also found that if the DTP vaccine were no longer mandatory, 12.8% of parents would “probably or certainly not” have their child vaccinated.
Second, the results of the qualitative survey conducted as part of the citizen consultation on vaccination indicate that the fact that a vaccine is recommended gives it an optional status, leading to questions about its usefulness, effectiveness, and safety. Conversely, the mandatory nature of a vaccination appears to have a positive effect on how it is perceived.
How do parents obtain information about vaccinations? The majority of parents report consulting a doctor to obtain information about vaccinations (81.3%), and more than a third (37.4%) conduct research online. These results confirm the major role doctors play in informing parents about vaccinating their children. Seeking information online is associated with lower vaccination rates, which highlights the need to strengthen and make information about the benefits of vaccines more accessible. The website vaccination-info-service.fr was created for this purpose.
As the first institutional website on vaccination aimed at the general public, Vaccination-info-service.fr provides factual, practical, and scientifically validated information to answer questions from the public seeking information on vaccination.
Animations, infographics, expert videos, and other multimedia content enhance the site to make the information as accessible and engaging as possible.
