Evolution between 2008 and 2018 of mothers' perception regarding vaccination and infant vaccine coverage in France.

OBJECTIVE: Monitoring of vaccination coverage rates (VCRs) is essential to assess the implementation of a country's vaccine policy and its effectiveness. Through the French Vaccinoscopy study, we measured the evolution of VCRs as well as mothers' opinion towards vaccination between 2008 and 2018, before and after implementation of infant mandatory vaccination extension. METHODS: This is a study based on an internet-standardised questionnaire. In 2018, a representative sample of 3000 mothers of infants 0 to 35 months of age answered on their opinion on vaccination and reported all vaccinations recorded in their child's health record. RESULTS: On the period considered, infant VCRs were stable and high for diphtheria, tetanus, poliomyelitis, pertussis and pneumococcus components and progressed for measles, mumps rubella, 2 doses at 24 months of age from 45.3% in 2008 to 81.0% in 2018, hepatitis B (HepB) complete primovaccination at 6 months of age from 45.9% in 2008 to 86.3% in 2017 and 95.5% in 2018, and meningococcus C (MenC) 1 dose at 6 months of age from 43.0% in 2017 to 74.2% in 2018. In 2018, 69.0% of mothers were in favour of vaccination while this rate dropped from 80.2% in 2012 to 64.0% in 2017, and 80.8 to 89.6% perceived HepB, MenC measles and pertussis vaccinations as useful/essential, percentages in progress versus 2017. CONCLUSION: Following the implementation of infant mandatory vaccination in 2018, proportion of mothers in favour of vaccination increased significantly. HepB and MenC VCRs significantly progressed between 2017 and 2018.

Infant mandatory vaccinations: Confirmation of a positive impact.

OBJECTIVE: Infant vaccines protecting against 11 diseases have changed from recommended to mandatory status in France for all children born from first of January 2018. Through Vaccinoscopie survey, we measured for the second consecutive year the impact of this new policy on vaccine coverage rates (VCRs) and mothers' perception regarding vaccination. METHODS: Web-based survey on a representative sample of 1500 mothers of 0 to 17-month-old infants. RESULTS: Non-optimal VCRs continued to increase in 2019 versus 2017 (according to age, +7 to 8 points VCR for Hepatitis B and +36 to 68 points for Meningococcus C). After a progressive decrease between 2012 and 2017, the rate of favorable mothers' opinion towards vaccination continued to progress in 2018 and 2019. CONCLUSION: These results confirmed the positive impact of this new law on infant VCRs and mothers' favorable opinion regarding vaccination.

Meningococcal C vaccine coverage in France in infants, children, and adolescents.

OBJECTIVES: Meningococcal C (MenC) vaccination was introduced in the French vaccination calendar in 2010 to reduce the incidence of invasive meningococcal C disease (IMDC), mainly through herd immunity. The Vaccinoscopie survey helps follow vaccination coverage rates (VCRs) of children. METHODS: This annual survey is based on a self-administered online questionnaire. In 2017, 4500 mothers of children completed the questionnaire and reported all vaccinations recorded in their child's health record. RESULTS: MenC vaccination was deemed indispensable or useful by 77% to 84% of mothers. The main barrier mentioned by mothers considering the vaccination useless/not very useful, was fear of adverse effects. VCR was estimated at 77% among 24-35-month-old infants, 79% among 6-year-old children, and 50% among 14-15-year-old adolescents. VCR strongly varied depending on the physician's advice for vaccination and on the type of follow-up. Six months after publication of the new French vaccine calendar in April 2017, with a MenC vaccine recommendation for all 5-month-old infants, 43% of infants had received a dose at 6 months of age. CONCLUSIONS: VCRs are insufficient to reach herd immunity. Between 2011 and 2017 more than 100 deaths could have been avoided in France if optimal VCRs had been achieved. Faced with this vaccine strategy failure, the new vaccine recommendation at 5 months of age seems well-accepted. This recommendation and the implementation of infant mandatory vaccination in 2018 should have a major impact on IMD C incidence in this age group.

Impact of mandatory vaccination extension on infant vaccine coverages: Promising preliminary results.

OBJECTIVE: In France infant vaccines protecting against 11 diseases have changed from a recommended to a mandatory status for all children born on or after January 1, 2018. Using the Vaccinoscopie survey, we measured the impact of this new vaccination policy on vaccine coverage rates (VCRs) and on mothers' perception of vaccination. METHODS: Online survey with 1000 mothers of 0- to 11-month-old infants. RESULTS: VCRs for at least one dose at the age of 6 months strongly progressed for diseases that previously did not meet Public Health objectives (+8 points for Hepatitis B and +31 points for meningococcal C vaccines). Mothers were more favorable to mandatory vaccination and better informed in 2018 than in 2017. CONCLUSION: These first results showed a positive impact of the extension of mandatory vaccination on mothers' opinion regarding vaccination and on infant VCRs.