Tuppin P, Samson S, Weill A, Ricordeau P, Allemand H
Direction de la stratégie des études et des statistiques, Caisse nationale de l'assurance maladie des travailleurs salariés (CNAMTS), 26-50, avenue du Professeur-André-Lemierre, 75986 Paris cedex 20, France.
Med Mal Infect. 2009 Oct;39(10):780-8. doi: 10.1016/j.medmal.2009.08.013. Epub 2009 Sep 30.
The French general health insurance scheme has implemented a national influenza vaccination program including full refund for those 65 years old or more and those under 65 years of age with a targeted chronic disease.
Our aim was to evaluate vaccination coverage (VC) according to sex, age, targeted chronic disease and geographical regions.
Data on vaccination refund for patients covered by the general health insurance scheme (85% of French population) was collected from the refund information system for the 2007-2008 campaign.
Among the 11,618,719 targeted individuals, the overall VC was 51.5% (9.6% for individuals <10 years of age, 15.0% between 10 and 19, 28.1% between 20 and 64, and 63.3% for 65 individuals years of age or more). For those under 20 years of age, VC rates were inferior to 35% for targeted groups except for cystic fibrosis (67%). Among individuals 65 years of age or more, VC was 63.3%. The VC was 74.1% for people 65 years old or more with at least five refunds 6-months before vaccination (80% of the group) and for the others it was under 30%. The frequency of refund, vaccination for the 2006/2007 campaign, and having an attending physician were associated with an increased VC.
Refund data is useful to determine and understand VC among target groups, to build specific strategies among those groups and to assess their impact. VC could be underestimated because some target individuals may be vaccinated through non-refundable procedures. Specific studies should improve the understanding of vaccination attitudes in targeted groups.
法国全民健康保险计划实施了一项全国性流感疫苗接种计划，为65岁及以上人群以及65岁以下患有特定慢性病的人群提供全额费用返还。
我们旨在根据性别、年龄、特定慢性病和地理区域评估疫苗接种覆盖率（VC）。
从2007 - 2008年度活动的费用返还信息系统中收集了全民健康保险计划覆盖人群（占法国人口的85%）的疫苗接种费用返还数据。
在11,618,719名目标人群中，总体疫苗接种覆盖率为51.5%（10岁以下人群为9.6%，10至19岁人群为15.0%，20至64岁人群为28.1%，65岁及以上人群为63.3%）。对于20岁以下人群，除囊性纤维化患者（67%）外，目标群体的疫苗接种覆盖率低于35%。在65岁及以上人群中，疫苗接种覆盖率为63.3%。在接种疫苗前6个月至少有5次费用返还的65岁及以上人群（占该群体的80%）的疫苗接种覆盖率为74.1%，其他人群则低于30%。费用返还频率、2006/2007年度活动的疫苗接种情况以及有主治医生与疫苗接种覆盖率增加相关。
费用返还数据有助于确定和了解目标群体中的疫苗接种覆盖率，制定这些群体中的具体策略并评估其影响。由于一些目标个体可能通过不可返还费用的程序接种疫苗，疫苗接种覆盖率可能被低估。具体研究应增进对目标群体疫苗接种态度的理解。
