Dommergues M-A, Robichon F, Soltane S, Refol S, Panel P, Foucaud P
Service de pédiatrie, centre hospitalier de Versailles, Le Chesnay, France.
Arch Pediatr. 2009 Sep;16(9):1270-5. doi: 10.1016/j.arcped.2009.06.011. Epub 2009 Jul 25.
The early vaccination with BCG of children with a high risk of tuberculosis straight from the maternity hospital has been recommended since October 2005. However, this recommendation has not often been followed. Practitioners feared that the suspension of the mandatory character of the BCG vaccine dating from July 2007 would result in a decrease in vaccine coverage. The goal of this study was to assess a program for early vaccination with BCG in the maternity hospital for high-risk children.
Intradermal vaccination with BCG-SSI of high-risk newborns, as defined by the Conseil Supérieur d'Hygiène Publique de France, at the maternity hospital of Versailles from May 2007 to May 2008.
Six hundred and sixty children (35% of births with a sex ratio of 1.13) fulfilled criteria for vaccination in the maternity hospital. Among the high-risk newborns, 596 (89%), were vaccinated. The geographic origin of one or both parents was the main indication (98.6%) for the vaccination. Three main practitioners (two pediatricians and one nurse) performed 72.6% of the BCG intradermal injections. The other BCG vaccinations were given by occasional practitioners: pediatricians, a midwife, or medical students. A papule was subsequently observed more often when the practitioner was experienced: 96.8% for the main practitioners, 83.5% for the occasional practitioners. Fifty-six (8.3%) parents refused vaccination for their eligible newborn.
From our experience, the early vaccination of the at-risk of tuberculosis newborn is well accepted in the maternity hospital and presents very few technical problems for an experienced team.
自2005年10月起，就已建议对直接来自妇产医院的结核病高危儿童尽早接种卡介苗。然而，这一建议并未经常得到遵循。从业者担心，2007年7月起卡介苗不再具有强制性会导致疫苗接种覆盖率下降。本研究的目的是评估一项针对妇产医院高危儿童的卡介苗早期接种计划。
2007年5月至2008年5月，在凡尔赛妇产医院对法国最高公共卫生委员会定义的高危新生儿进行卡介苗-丹麦株皮内接种。
660名儿童（占出生人数的35%，男女比例为1.13）符合在妇产医院接种疫苗的标准。在高危新生儿中，596名（89%）接种了疫苗。父母一方或双方的地理来源是接种疫苗的主要指征（98.6%）。三名主要从业者（两名儿科医生和一名护士）进行了72.6%的卡介苗皮内注射。其他卡介苗接种由临时从业者进行：儿科医生、一名助产士或医学生。当从业者经验丰富时，随后观察到丘疹的情况更常见：主要从业者为96.8%，临时从业者为83.5%。56名（8.3%）家长拒绝为其符合条件的新生儿接种疫苗。
根据我们的经验，妇产医院对结核病高危新生儿进行早期接种很容易被接受，对于经验丰富的团队来说技术问题很少。
