Introduction – Besides the classical data sources that have been used for many years (including child health certificates and school surveys), other sources may be useful for the evaluation and monitoring of vaccination coverage.
Methods – We identified the main new tools that can be used in the evaluation of vaccination coverage. The advantages and disadvantages of each one were assessed. Each tool was classified as relevant or not for the routine assessment of vaccination overage.
Results – Vaccine sales allow the follow-up of vaccination activity trends; however, they do not allow the calculation of immunization coverage.
Conclusions – EGB data allow a rapid update of national vaccination coverage estimates in children whatever their age, and for all recommended vaccines provided that they are reimbursed. Subnational coverage estimations will be provided by the DCIR database. None of these new tools are suitable for the evaluation of vaccination coverage among adults.
Estimation of vaccination coverage in France through the Permanent Beneficiaries Sample (EGB): example of measles, hepatitis B and human papillomavirus vaccination
Introduction – Vaccination coverage (VC) in children and teenagers is estimated using 24th months health certificates data and through school surveys.
Although both tools allow reliable estimations of vaccination coverage, data are available only several years after the vaccination is performed. We used the Permanent Beneficiaries Sample (“Échantillon généraliste des bénéficiaires”, EGB) for the estimation of vaccination coverage, in order to improve the timeliness of coverage measurement. We present here measles, mumps, rubella (MMR), hepatitis B and HPV vaccination coverage data.
Method – The EGB is a representative sample of the population affiliated to the main French social security system. It contains for each individual his/her past vaccine reimbursements history.
Results – For children born in 2009, MMR vaccination coverage at 24 months of age was 90.4% and hepatitis B vaccination coverage was 58.2% for three doses in December 2011. For girls aged 15-17 years, 45.3% had begun HPV vaccination, and 29.9% had received the full vaccination scheme.
Discussion-conclusion – EGB data are consistent with health certificates data. This tool allows regularly updated reactive and reliable vaccination coverage estimations.
Follow-up of MMR vaccine sales data to assess the impact of a local awareness campaign on measles vaccination in 2011 in Auvergne, France
Introduction – A local awareness campaign for immunization against measles was implemented in two French districts of the Auvergne region by sending letters to parents early 2011 to address a measles outbreak. The objective of this study was to assess the impact of this action on vaccination coverage.
Materials and methods – Data from vaccine sales to pharmacies from the statistics committee GERS were used over the period 1 September 2010 to 30 June 2011. The first indicator tested compared a post-action and preaction for a period of four months each, the second comparing monthly sales, and the third compared variations in the sales of MMR vaccine between the Auvergne and Rhône-Alpes regions to monitor the impact of the outbreak.
Results – A few months after the campaign, increases in MMR vaccine sales were significantly higher in districts where the campaign took place, regardless of the indicator used. Moreover, the increase in sales occurred soon after the action.
Discussion-conclusion – The use of vaccine sales data to pharmacies provided by GERS suggests a beneficial effect of raising awareness on immunization coverage through indicators, although it is not possible to estimate the share attributable to this action. The lack of declination by age data from vaccine sales is the main limitation of this source.
Meningitis C vaccine coverage estimate from reimbursement aggregated data in Finistère District, France, among 1 to 24 years old people
Context – Facing an increase of meningitis C incidence, a study was carried out from the Système national d’information inter-régimes de l’assurance maladie (SNIIRAM) aggregated dataset to test the hypothesis of an insufficient meningococcal C vaccine coverage (VC) in the Finistère District (France) among 1-24 years old who are targeted by the vaccine recommendations.
Material and methods – Age aggregated (1-4 years, 5-9 years, 10-14 years, 15-19 years, 20-24 years) numbers of conjugate vaccine doses reimbursed in 2010 and 2011 were used and divided by Insee population estimates for 2009.
Results – 1-24 years vaccine coverage was equal to 20.1% in Finistère, 18.5% in Brittany, and 19.4% in France outside Brittany. Finistère 1-4 years coverage was 5% lower than that of France outside Brittany (42.2 vs. 47.3%, p<0.001). It was slightly higher in all other age-groups.
Discussion-conclusion – Meningococcal C VC was not sufficient among 1-24-years to induce herd immunity to the rest of the population. However, the Finistère situation is not particular in France. In an emergency situation, the SNIIRAM aggregated data contributed to quickly estimate VC. Our results were consistent with those available at the national level from the Permanent Beneficiaries Sample (EGB). This analysis contributed to issue new recommendations by French public health authorities in order to reinforce vaccination among 1-24 years old in Finistère, promote vaccination in the rest of France among 1-24-years old, and temporarily propose it to 2-11 months old children in Finistère.