Determinants of incomplete vaccination in children at age two in France: results from the nationwide ELFE birth cohort

Abstract Incomplete vaccination in the pediatric population is a growing public health issue in high-income countries, but its determi-nants are poorly understood. Their identification is necessary to design target actions that can improve vaccination uptake. Our aim was to assess the determinants of incomplete vaccination in two-year-old children in France. Among the 18,329 children included in the 2011 ELFE French nationwide population-based birth cohort, we selected those for whom vaccination status was available at age two years. Incomplete vaccination was defined as > 1 missing dose of recommended vaccines. Potential determinants of incomplete vaccination were identified by using logistic regression, taking into account attrition and missing data. Of the 5,740 (31.3%) children analyzed, 46.5% (95% confidence interval [CI] 44.7–48.0) were incompletely vaccinated. Factors independently associated with incomplete vaccination were having older siblings (adjusted odds ratio 1.18, 95% CI [1.03–1.34] and 1.28 [1.06–1.54] for one and ≥ 2 siblings, respectively, vs. 0), residing in an isolated area (1.92 [1.36–2.75] vs. an urban area), parents not following health recommendations or using alternative medicines (1.81 [1.41–2.34] and 1.23 [1.04–1.46], respectively, vs. parents confident in institutions and following heath recommendations), not being visited by a maternal and child protection service nurse during the child’s first two months (1.19 [1.03–1.38] vs. ≥ 1 visit), and being followed by a general practitioner (2.87 [2.52–3.26] vs. a pediatrician).

Conclusions: Incomplete vaccination was highly prevalent in the studied pediatric population and was associated with several socio-demographic,

M.Jacques et al