Determinants of tetanus, diphtheria and poliomyelitis vaccinations among Hajj pilgrims, Marseille, France.
BACKGROUND
It has been observed that Muslim pilgrims departing France for Mecca have low national immunization rates against tetanus, diphtheria and poliomyelitis (TdP). Our purpose is to identify immigration, socio-economic and socio-cultural determinants of vaccination coverage against TdP.


METHODS
A cross-sectional survey study was conducted in late 2006 among 580 pilgrims in preparation who attended the Infectious and Tropical Medicine ward in Hôpital Nord at Marseille to receive their N. meningitidis vaccine required for travel to Mecca.


RESULTS
Total vaccination rates for tetanus (18.9%), diphtheria (14.7%) and poliomyelitis (15.0%) were comparable. Pilgrim's characteristic lower socio-economic and social status, in addition to their unifying linguistic, cultural and religious identity defines them as a particularly disadvantageous group in France. French citizenship, higher level of education, better French fluency and no previous travel to country of origin were the strongest and most significant determinants of TdP vaccination status.


CONCLUSIONS
These results suggest that the Muslim community in France is at risk from inequities of national preventive care efforts.
Gautret
Philippe
P
Service des Maladies Infectieuses et Tropicales, Hôpital Nord, AP-HM, Marseille, France. philippe.gautret@club-internet.fr
Yong
Winnie
W
Soula
Georges
G
Parola
Philippe
P
Brouqui
Philippe
P
DelVecchio Good
Mary-Jo
MJ
D000293:Adolescent; D000328:Adult; D004165:Diphtheria / Q000517:prevention & control*; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D005260:Female; D005602:France; D006801:Humans; D007514:Islam; D008297:Male; D008875:Middle Aged; D011051:Poliomyelitis / Q000517:prevention & control; D013742:Tetanus / Q000517:prevention & control; D014195:Travel; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines