Why it is complicated to vaccinate your child in Paris

It is not mandatory but it is recommended, but at the same time it is not really available. In Paristhe vaccine against tuberculosis (BCG) can easily make young Parisian parents dizzy. Let’s try to see it more clearly.

Why is the vaccine recommended and is it no longer required?

Based on the recommendations of theWHO and other European countries, the Superior Council of Public Health (HCSP) “recommends that the practical threshold to define a country with high tuberculosis endemicity is an annual incidence of tuberculosis disease > 40/100,000 inhabitants”, recalls the regional health agency (ARS) of Ile-de-France. And therefore take this threshold to decide whether or not vaccination is required. Up is yes, down is no.

In France there are 7.6 declared cases per 100,000 inhabitants in 2020, so compulsory vaccination is not necessary. But in Ile de France, the situation is significantly different, specifies the ARS. In 2020, 4,606 cases of tuberculosis were reported in France, including 36% in Ile-de-France. This makes for this same year a tuberculosis declaration rate of 14.3/100,000 inhabitants, or twice the national rate. “That’s why it was decided [avis du HCSP du 1er février 2013] to maintain surveillance over certain territories, including Ile-de-France, indicates the ARS. For this reason, vaccination of children born in Ile-de-France is recommended. »

Why is the rate higher in Ile-de-France?

Simply because Ile-de-France is a region with a great “openness to the world”, as recalled Paris City Hall, where many people from countries with a high endemicity of tuberculosis settle, according to the expression of the ARS. The Paris consistory also advances the explanation of the population density in the region, which may favor the transmission of the disease.

Why is it difficult to get vaccinated in the capital?

“Since 2016 we have been in a phase of global shortage of BCG vaccines linked to manufacturers,” explains the Paris city council. As a result, these are rationed and each department receives a specific allocation. This has several consequences. Vaccines are no longer accessible in pharmacies but “limited to the following structures: PMI centers, vaccination centers, tuberculosis control centers and maternity wards,” specifies the ARS. “Children are vaccinated according to priority criteria, if they live in dense households, if their family has traveled a lot to countries at risk, for example in the case of migratory routes,” the Paris city council lists.

Another difficulty is that the vaccine is supplied in bottles of ten doses, so “we cannot take patients on the go, we need appointments so as not to miss the doses, the deadlines are linked to that,” specifies the Paris consistory. The latter also reports difficulties in recruiting doctors in popular neighborhoods, capable of administering the vaccine. This explains why it is sometimes necessary to wait several months to obtain an appointment for vaccination in these districts.

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