Meyran M, Buisson Y, Desfontaine M
Chaire d'épidémiologie et prophylaxie du Val-de-Grâce.
Bull Acad Natl Med. 1993 Dec;177(9):1539-45; discussion 1545-8.
The history of military medicine has always been closely linked with that of vaccinations. Doctors of Armed Forces, doctors of collectivities, have contributed to vaccination progresses in large amounts. But evolutions are often rapid here: epidemiological modifications, improvements in the existing vaccines or creation of new vaccines, diversification of military specificities. Three recent modifications in the vaccination schedule of the Armed Forces show this necessary adaptation: Systematization of the meningococcal A + C vaccination during the incorporation, because of the modification of the disease's epidemiological profile: increase of the frequency in serogroup C with a mortality increase (9 cases of death out of 10 observed between 1991 and 1992). Cancellation of antityphoïd vaccination for recruits serving in home country. Indeed the disease has become rare in France, and this is often due to imported cases (3 cases in the Armed Forces in 1992). Introduction in 1994 of vaccination against viral hepatitis A, systematic under the age of 25 years and after a serological selection above for servicemen having to serve overseas or for outside operations. These 3 examples show the necessity to have updated and adaptable vaccination schedules.
军事医学的历史一直与疫苗接种的历史紧密相连。武装部队的医生、集体机构的医生为疫苗接种的进展做出了巨大贡献。但这里的发展往往迅速:流行病学的变化、现有疫苗的改进或新疫苗的研发、军事特性的多样化。武装部队疫苗接种计划最近的三项调整表明了这种必要的适应性:由于疾病流行病学特征的改变,在入伍时将A+C型脑膜炎球菌疫苗接种系统化,因为C群的发病率增加且死亡率上升(1991年至1992年期间观察到的10例死亡中有9例)。取消在本国服役新兵的伤寒疫苗接种。事实上,这种疾病在法国已变得罕见,且往往是输入性病例(1992年武装部队中有3例)。1994年引入甲型病毒性肝炎疫苗接种,25岁以下军人系统性接种,对于必须在海外服役或执行外部行动的军人,在此年龄以上需经过血清学筛选后接种。这三个例子表明有必要制定更新且适应性强的疫苗接种计划。