Laure Fonteneau

BACKGROUND: Vaccination of residents and healthcare workers (HCWs) against influenza in nursing homes is an important prevention strategy. AIM: To describe trends in influenza vaccination coverage (VC) among HCWs working in nursing homes in France and measures implemented to support vaccination campaigns from 2007 to 2025, and to identify effectiveness of these measures. METHODS: We analysed data from seven nationwide cross-sectional studies conducted between seasons 2007/08 and 2024/25 and performed multivariate analysis using negative binomial regressions, to identify determinants. RESULTS: National influenza VC among HCWs decreased from 37.2% (95% CI: 35.7–39.4) in 2007/08 to 24.2% (95% CI: 23.2–25.1) in 2024/25 (mean: 39,740 HCWs per season, 6 seasons). Vaccination coverage disparities by category of HCWs (2024/25 VC of physicians: 56.3%; nurses: 34.2%; nursing assistants: 19.3%) were observed throughout the period. Measures to promote influenza vaccination were less frequently implemented over time: support of vaccination campaigns by the management team (from 2018/19: 89% to 2024/25: 52%), implementation of collective (68% to 49%) or individual information sessions (19% to 9%), distribution of information on influenza vaccines (64% to 53%) or influenza (83% to 69%). Seven measures exhibited effectiveness in 2018/19 compared to only four in 2024/25, which had less effectiveness. Management teams highlighted the strong reluctance of HCWs to receive influenza vaccination. CONCLUSIONS: Influenza VC among HCWs in nursing homes is marked by disparities among professional categories. To mitigate the decline in VC among HCWs, it is essential to implement effective measures to support the campaigns.

Introduction: Since the late 2000s, several major measles epidemics have occurred in Europe, including France. In 2017, the French Health Ministry extended from three to 11 the number of mandatory childhood vaccines required for preschool and primary school admission; these included the vaccine against measles, mumps and rubella (MMR). Aim: Our aim was to assess if this measure helped to improve MMR vaccine timeliness (VT) or reduce socioeconomic inequalities in MMR vaccine coverage. Methods: A nationwide study of three birth cohorts (2015, 2017, 2019) followed up 2.1 million children for 48 months to assess the course of the timeliness of MMR vaccine dispensation, before and after it became mandatory in France (January 2018). Data came from the French national health insurance fund drug reimbursement database. Results: Despite improvements from 2015 to 2019, pharmacies dispensed MMR vaccines late for 33% of children in the 2019 cohort (mean cumulative delay compared with recommended dates: 7.1 months). Vaccines for children from low-income families were dispensed later (mean delay of at least +1 month) than those from higher-income families. The 2019 cohort did not reach the 95% WHO target of two MMR doses at 24 months of age, nor at 48 months. Discussion: With measles intensifying worldwide, these vaccination delays and inequalities may contribute to the resurgence of epidemics. In addition to vaccination mandates, an ambitious public health policy is needed to reduce inequalities in access to vaccination and to improve parents’ vaccine acceptance through educational strategies.