[Low pneumococcal conjugated vaccine immunization coverage in low-income families: a study in Île-de-France].
OBJECTIVE
Socio-economic inequalities in access to vaccination are poorly documented in France. This study analyzed socio-economic inequalities in pneumococcal conjugate vaccine (PCV7) immunization coverage, the cost of which is about 180 € for three doses.


METHODS
We conducted a cross-sectional survey including children aged 0-5 years living in Paris and its immediate suburbs, selected by a stratified two-stage random sampling design. Data were collected in a face-to-face interview. Vaccination coverage, confirmed by a document, was measured for the first dose and the full primary vaccination series. Poisson regression was used to analyze the association between PCV7 vaccination coverage and several socio-economic and demographic factors.


RESULTS
Vaccination coverage for the first dose was 93.7% and 76.7% for the full primary vaccination series. The first-dose vaccination coverage in children from lower income families (first quartile of income) was lower than that of children from higher income families (83.2% versus 97.3%, P=0.033). A similar result was also observed for the full primary vaccination series, although this result was not statistically significant (65.5% versus 87.6%, P=0.09). Full coverage was lower in children with only basic health insurance (70.2%) than in children with additional health insurance either through social assistance (81.4%) or through private insurance (76.1%), but these differences were not significant.


CONCLUSIONS
The association of low PCV7 vaccination coverage with low family income suggests the existence of financial barriers to vaccination in the poorest families. However, the lack of a statistical association with the type of health insurance could also indicate the existence of obstacles to vaccination other than purely financial.
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. Electronic address: jp.guthmann@invs.sante.fr.
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JP
Guthmann
Inserm, UMRS 707, équipe DS3, 75012 Paris, France; Université Pierre-et-Marie-Curie, Paris 6, UMR-S 707, 75012 Paris, France.
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P
Chauvin
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.
Y
Y
Le Strat
Inserm, UMRS 707, équipe DS3, 75012 Paris, France; Université Pierre-et-Marie-Curie, Paris 6, UMR-S 707, 75012 Paris, France.
M
M
Soler
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.
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L
Fonteneau
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.
D
D
Lévy-Bruhl
D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health; D007407:Interviews as Topic; D008297:Male; D015999:Multivariate Analysis; D022242:Pneumococcal Vaccines / Q000191:economics*; D011203:Poverty; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*
D022242:Pneumococcal Vaccines