Public health impact of Infanrix hexaℿ(DTPa-HBV-IPV/Hib) reimbursement: A study programme in France. Part 1: Evolution of hepatitis B vaccine coverage rates in infants aged less than 27 months, in the general population - the PopCorn study

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• 作者：J. Gaudelus^a ; ^{joel.gaudelus@jvr.aphp.fr" class="auth_mail" title="E-mail the corresponding author} ; F. Vié ; le Sage^b ; V. Dufour^c ; F. Lert^d ; N. Texier^e ; M. Pouriel^e ; B. Tehard^f ; ¹ ; G. Bré ; art^g
• 关键词：Hepatitis B ; Reimbursement ; Vaccine coverage ; General population ; Children ; France ; Public Health
• 刊名：Revue d'épidémiologie et de Santé Publique
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：64
• 期：1
• 页码：23-32
• 全文大小：1064 K

文摘

Reimbursement of the hexavalent vaccine (Infanrix hexa™) comprising the DTPa-IPV-Hib components and the hepatitis B valence in a single vaccine was decided in March 2008 in France. The impact of its reimbursement on the hepatitis B vaccine coverage rate was assessed in a study conducted in the general population prior to and after implementation of the reimbursement policy.

Methods

The PopCorn study (NCT01782794) was a national, cross-sectional and repeated study, with four assessment periods over 3 years, from 2009 to 2012, to assess the hepatitis B vaccine coverage in 12- to 15- and 24- to 27-month-old children, vaccinated between 2007 and 2011 and selected by the quota sampling method. Face-to-face interviews were conducted at their homes and vaccination status was collected using their child's health record. Parents were also interviewed on their perceptions and acceptance of hepatitis B vaccination. Three indicators were calculated to assess hepatitis B vaccination coverage: proportions of infants with at least one dose before 6 months of age, with at least two doses before 6 months of age and with a complete schedule at 24 months of age.

Results

A total of 4903 children were enrolled in the study. An overall significant increase (P-value [P < 0.05]) of the three indicators of interest over the four periods of time was observed for both age groups. The proportion of children receiving hepatitis B vaccination before 6 months increased from 21% at baseline (before vaccine reimbursement) to almost 75% at the last assessment period in 2012. More than 60% of 24- to 27-month-old children received a complete schedule in 2012 compared to 33% at baseline. No significant increases in the proportions of parents “favourable” and “moderately in favour” of hepatitis B vaccination were observed across the four evaluation periods (respectively, 17–22% and 48–50%, P = 0.09).

Conclusion

The rapid increase of hepatitis B vaccination coverage suggests a significant change in hepatitis B vaccination practice related to the hexavalent vaccine's reimbursement. This change was observed in a context of stability regarding parents’ perceptions and acceptance of hepatitis B vaccination and of coverage rates for other infant vaccinations.