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 Coverage remains insufficient overall adolescents, especially vis-à-vis four infectious diseases (measles, whooping cough, hepatitis B and HPV infection) and only 32.6% of the population, that is to say less a teenager in three days are for all of their vaccines (diphtheria, tetanus, polio, mumps and rubella, in addition to the first mentioned), warned Dr. Georges Picherot, in the Department of Pediatrics at the University Hospital of Nantes.

Coverage necessary to eliminate measles (at least 95% for the first dose at 24 months and 80% for the second dose) is far from being achieved, can be read in the press. A survey of 6,144 students in CM2 (1,000 schools) with a median age of 11 years, showed that the great majority (95.7%) received a first dose, but only 74.2 % (ie 3 out of 4 children) received the second.

However, while measles seemed controlled even in the years 2006-2007 disease, a sharp increase has been observed since the end of 2008, indicating active virus circulation and insufficient coverage (604 cases reported in 2008, versus 40 in 2007 and 802 cases between January 1 and May 31, 2009, of which 20% hospitalized, two acute encephalitis and death). One third of cases reported in 2008 was over 15 years and these later forms are also proving more severe, with a higher risk of complications.

In this context, the High Council of Public Health (HCSP) has issued a new notice stating that the vaccination measures recommended by the NPP are applied with a two-dose vaccination of all infants and a catch-up children, adolescents and young adults not vaccinated.

About pertussis immunity acquired in childhood and decreases with the years, so a patient may have two to three times the disease during its existence. The average duration of induced protection is estimated at 12-15 years for infection and 8-10 years for the vaccine. The importance of vaccinating adolescents and young adults is to avoid not only people vaccinated for the disease but also a transmission to their surroundings, especially to infants less than two months, where pertussis is the leading cause Community bacterial death.

A catch-up vaccination is now recommended between 16 and 18 adolescents who did not receive the vaccine between 11 and 13 years (combined vaccine dTPca: diphtheria-tetanus-pertussis-poliomyelitis, plus low-dose).

HEPATITIS B AND PROBLEM VACCINATON HPV VACCINATION INSUFFICIENT

Vaccination against hepatitis B remains problematic, with coverage having declined significantly between 2003 and 2004 and less than one in two adolescents vaccinated: coverage is actually increased from 62.4% to 42.4 % in 2003-2004.

In April 2009, the HCSP, therefore, advocated the use of a simplified immunization schedule with only two doses instead of three adolescents between 11 and 15 years, not previously vaccinated using a vaccine with marketing authorization for this schema.

Finally, HPV infections often occur during adolescence, affecting more than 2 out of 3 women. If the virus is spontaneously eliminated in 90% of cases, the infection persists in 10% of cases and can cause cancer of the cervix in the longer term, each year 3,000 new cases and more than 1,000 deaths and 50,000 women undergoing specific treatment for precancerous lesions caused by HPV.

Only vaccine specifically recommended at the age of 14, it is possible to make a catch between 15 and 23 or at the latest within one year after the start of sexual life, HCSP and CTV (Technical Committee on Vaccinations ) recommending preferentially quadrivalent (6,11,16,18 strains). Knowing also that vaccination is not effective in preventing approximately 30% of cancers of the cervix and it is no substitute for regular Pap screening of cervical cancer at the beginning of sexual life.

ADOVAC: A PRACTICAL GUIDE TO THE VACCINATIONS ADO

To improve vaccination coverage in this population of young people, "vaccine Advanced" panel of experts in vaccinology, supported by Sanofi Pasteur MSD has developed a practical guide carrying out the synthesis of recommended vaccinations in adolescents aged 11 to 18 years .

This booklet has three sections: the vaccine appointment, the catch-up vaccinations, specific vaccinations.

Vaccine appointments are three in number:

- To 11-13 years for the reminder diphtheria-tetanus-pertussis-poliomyelitis (combined vaccine dTPca);

- 14 years for HPV infections in young girls;

- 16-18 years for the DTP booster.

The catch-up vaccinations include:

- A combination vaccine dTPca 16-18 years adolescents who did not receive their pertussis booster at 11-13 years;

- The vaccine against hepatitis B for 11-15 years previously unvaccinated (possibility of two-dose regimen);

- Did not have an HPV vaccine for girls and young women aged 15 to 23 years of sex or no later than one year after the beginning of their sexual lives;

- The MMR vaccine for teenagers born in 1991 who had never been vaccinated against measles (knowing that those born since 1992 should have received two doses of MMR).

Specific vaccinations are those against influenza and pneumococcal disease for young people with an underlying pathology that against chickenpox for 12-18 years who have never developed the disease.