Hepatitis B vaccination and French Society ten years after the suspension of the vaccination campaign: How should we raise infant immunization coverage rates?

In 1998, official concerns were first voiced over a possible association between hepatitis B virus (HBV) vaccination and multiple sclerosis (MS). Despite a number of studies that have demonstrated no such association, ten years on the French population's confidence in the vaccine remains shaken and immunization rates of infants have stagnated beneath 30%. With a chronic carriage of the virus estimated at 0.68%. it seems unlikely that France will be able to control the circulation of the virus. This article analyses attitudes towards HBV vaccination based on recent surveys: not only the public but also the vast majority of "vaccinators" (88%) questions the safety of the vaccine. Physicians opposed to vaccinating infants cite the possibility of adverse events occurring later in life and their lack of trust in the health authorities and the pharmaceutical industry. Both the general public and physicians feel more inclined to vaccinate adolescents and adults, even though it was for these age groups (especially the latter) that neurological adverse events were notified. It appears that above all, the usefulness of the vaccine and its safety profile for young children should be explained in understandable language by all those involved in public health, including the media. However, when opting for public health policies on the basis of statistical estimations, the importance of individual cases (e.g. MS in the family) should not be overlooked both for biological and ethical reasons. (C) 2009 Elsevier B.V. All rights reserved.