title: [BCG vaccination coverage in children born after the end of compulsory BCG vaccination and followed in maternal and child health clinics in France: a national survey 2009].
abstract: OBJECTIVE
  Compulsory BCG vaccination was replaced in July 2007 by a strong recommendation to vaccinate children at high risk of tuberculosis. We measured BCG vaccination coverage (VC) in children for whom BCG is recommended, who were born after the end of compulsory BCG vaccination and are usually followed at Maternal and Child Health Clinics (MCHC).
  
  
  METHODS
  National sampling survey stratified by region and age group. Sample size was calculated in order to perform a separate analysis in Ile-de-France, region which has a specific vaccination policy and the highest tuberculosis incidence in mainland France. Children were selected through 2-stage random sampling in IDF and 3-stage random sampling outside IDF. They were recruited at the MCHC during the consultation where information was collected by the doctor through a structured questionnaire.
  
  
  RESULTS
  BCG-VC was 89.8% (81.4-94.7) in IDF and 61.7% (53.8-69.0) outside IDF. In IDF, VC in children who had other criteria than solely residing in IDF was 92.4%. Outside IDF, children were on average vaccinated later than in IDF (i.e.: VC at the age of 3 months in children aged 2-12 months: 84% in IDF, 42% outside IDF). In both zones, children aged 2-12 months were vaccinated earlier compared to those aged >12 months.
  
  
  CONCLUSIONS
  VC are high in children followed at MCHC in IDF, but can still be improved. They are insufficient in those followed at MCHC outside IDF where children are vaccinated too late. Efforts aimed at improving the dissemination of BCG vaccination recommendations and a better training of doctors in performing intradermal BCG vaccination could facilitate the implementation of this new BCG vaccination policy.
authors.affiliation: Unité des maladies à prévention vaccinale, département des maladies infectieuses, institut de veille sanitaire (InVS), 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France. jp.guthmann@invs.sante.fr
authors.forename: J-P
authors.initials: JP
authors.lastname: Guthmann
authors.forename: L
authors.initials: L
authors.lastname: Fonteneau
authors.forename: L
authors.initials: L
authors.lastname: Desplanques
authors.forename: D
authors.initials: D
authors.lastname: Lévy-Bruhl
mesh_terms: D001500:BCG Vaccine / Q000008:administration & dosage*; D002648:Child; D005602:France / Q000453:epidemiology; D006291:Health Policy / Q000331:legislation & jurisprudence; D006306:Health Surveys; D006771:Hospitals, Maternity / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data; D032541:Mass Vaccination / Q000592:standards; D011159:Population Surveillance; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D001500:BCG Vaccine