[Vaccination practices following the end of compulsory BCG vaccination. A cross-sectional survey of general practitioners and pediatricians].
BACKGROUND
Tuberculosis prevention has been based on generalized BCG vaccination in France since 1949. The aim of this cross-sectional survey was to assess the impact of the change in BCG administration (in January 2006) and the end of compulsory vaccination (in July 2007).


METHODS
A self-administered postal questionnaire was sent to a random sample of 2248 physicians practicing in 6 departments in the Rhône-Alpes region in 2008.


RESULTS
Overall, 923 questionnaires were analyzed. The median age of the respondents was 52 years, 67 % were male, 93 % were general practitioners, and 91 % practiced in private practice offices. The median number of BCG vaccines administered on a quarterly basis was 5 (interquartile range [IQR], 3-10) before January 2006, one (IQR, 0-3) between January 2006 and July 2007, and zero (IQR, 0-1) after July 2007 (P<0.001). The rate of BCG vaccination was significantly lower for male physicians, physicians older than 50 years, general practitioners, practitioners working in private offices, and for some departments. Thirty-nine percent of the physicians were informed of the national program against tuberculosis 2007-2009, and 41 % wished to be trained in the practice of intradermal vaccination.


CONCLUSIONS
This survey suggests that the withdrawal of Monovax and the lifting of generalized vaccination requirements were followed by a substantial decrease in the number of BCG vaccinations. The intradermal route constitutes an obstacle for BCG vaccination that might be overcome by specific training.
Wattrelot
P
P
Unité d'évaluation médicale, pavillon Taillefer, CHU, BP 217, 38043 Grenoble cedex 9, France. utmin2@hotmail.com
Brion
J-P
JP
Labarère
J
J
Billette de Villemeur
A
A
Girard-Blanc
M-F
MF
Stahl
J-P
JP
Brambilla
C
C
D000328:Adult; D000367:Age Factors; D000368:Aged; D001500:BCG Vaccine / Q000008:administration & dosage*; D002648:Child; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005602:France; D006306:Health Surveys; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D010372:Pediatrics / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011331:Private Practice / Q000706:statistics & numerical data; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control*
D001500:BCG Vaccine