Development of the vaccine policy in France

The evaluation of the vaccine policy

Measurements of the vaccine cover rate
They are carried out mainly for nourrissons, on the basis of certificate of health of children the 2 year old, gathered at the departmental level by the services of SME and exploited by the Management of research, the studies and statistics (DREES) of the ministry charged D health. 
Other investigations allow this measurement of the vaccine cover of the children, one is carried out in the 4 year old children by the services of SME, the other in the 6 year old children by the school health services.
There are not regular data of vaccine cover at the national level at the teenager or the adult, apart from studies carried out in certain category or age brackets of population (in particular, until little, by the health service of the armies) or for certain vaccines.

Data of monitoring of the diseases with vaccine prevention
The epidemiologic monitoring of the diseases with vaccine prevention is based on several systems of collection of the data:

·         the obligatory notification of the infectious diseases: diphteria, tetanus, poliomyelitis, tuberculosis, hepatitis B, yellow fever, typhoid fever and paratyphoid, invasive infection with méningocoque, rage. These notifications are collected by the departmental Directions of the businesses medical and social (DDASS), and analyzed at the national level by the Medical Institute of Day before. 

·         networks of general practitioners: network "sentinels" of unit 444 of the INSERM which collects data on hepatitises, the grippaux syndromes, measles, the mumps, chicken pox, and network of the doctors taking part in the regional Groupings of observation of influenza (GROG). 

·         networks of laboratories and hospital: RENACOQ for the whooping-cough, EPIBAC (infections with pneumococci,  Haemophilus influenzae, méningocoques), RENARUB (rubéoleuses infections during the pregnancy), Inspection Network of Entérovirus for the poliomyelitis. 

·         data of the national Centers of reference for the transmissible diseases (bordetelles, influenza, measles, méningocoques, mycobacteries, rage, Haemophilus influenzae,  entérovirus, viral hepatites, atypical pneumococci, tuberculosis and mycobacteries etc.

·         obligatory declarations of the causes of death (CépiC, in the past INSERM SC 8) 

·         specific seroepidemiologic studies: in particular a study relating to ladiphtery, the whooping-cough, measles, the mumps and rubella was carried out at the end of the Nineties starting from serums taken on a national sample of the French population of all ages.

Conclusion

On the whole, the French vaccine policy is based on:

·         a balance between obligations and recommendations 

·         an adaptation as narrow as possible to the evolution of the epidemiologic situations, new vaccines and the their bénéfices/risques ones 

·         periodic information campaigns intended to stimulate the convictions of the families and medical personnel with respect to certain diseases whose importance tends to be underestimated. 
The multiplicity of the vaccines and the injections just as the attention larger than one starts to carry in a vaccine state of the adults must lead: 

·         with new vaccine associations, 

·         in the search of means of slow diffusion of the vaccines (to reduce the number of injections of anatoxine) and other ways or vectors of administration, to improve information on vaccinations of the professionals of health and the public.

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