ABSTRACT
OBJECTIVES: To measure vaccine coverage among adolescents aged 16-18 years who participated in the National Defense Preparation Day in the Aquitaine region using the free electronic immunization record. PATIENTS AND METHODS: We considered adolescents aged 16-18 years who participated in the National Defense Preparation Day in the Aquitaine region from April to October 2013. All participants received a letter explaining how to create an electronic immunization record. Those records were then validated by checking data against the copies of the vaccination cards brought by participants on the day they attended. Vaccination coverage was estimated for eight vaccinations according to the cumulative number of doses registered and vaccines recommended during childhood. RESULTS: Among the 18,714 participants, 9636 agreed to create an electronic immunization record of which 2781 were validated. Vaccination coverage wasË90% for tuberculosis, diphtheria-tetanus-poliomyelitis, measles-mumps-rubella, and Haemophilus influenzae type B, andË90% for pertussis, hepatitis B, meningococcal C disease, and human papillomavirus. These coverage rates were close to those reported in other available sources. CONCLUSION: Our study calls attention to the insufficient vaccination of adolescents for pertussis, HBV, meningococcal C disease, and HPV. The absence of a system that routinely provides the vaccination status of this population is a major public health issue in France. The use of an electronic immunization record was innovative, but this tool is not extensively used in the general population and has been evaluated by Santé publique France (the French national public health agency).
Subject(s)
Electronic Health Records , Organizational Innovation , Vaccination Coverage/statistics & numerical data , Adolescent , Electronic Health Records/organization & administration , Electronic Health Records/statistics & numerical data , Electronic Health Records/trends , Female , France/epidemiology , Humans , Immunization Schedule , Male , Public Health/statistics & numerical data , Public Health/trends , Vaccination/statistics & numerical data , Vaccination/trends , Vaccination Coverage/organization & administration , Vaccination Coverage/standardsABSTRACT
We analyzed the influence of clinical and psychological factors on the long-term efficacy of botulinum toxin A (BTX) injections in 45 patients with blepharospasm and 66 patients with hemifacial spasm. Injections efficacy (respectively 94.3% and 95.7%) and duration of relief (respectively 14.8 and 18.7 weeks) remained stable over seven successive injections. Clinical improvement was not influenced by patients' sex, age, or disease duration but by psychological background (p < 0.001). Patients who failed to respond after repetitive injections had lower inter-injections intervals (p < 0.05). This data shows: (1) the importance of psychological contexte in subjective evaluation of treatment efficacy with BTX, (2) emphasizes the necessity of avoiding close injections.
