Non-access to vaccinations for the vulnerable children received by Doctors of the World in Europe
Bibliographic record
Abstract
Background Since 2006, the Doctors of the World - Médecins du Monde (MdM) International Network Observatory has been conducting multicenter surveys in Europe among vulnerable people – the vast majority of whom are immigrants – who make use of its national programs, in order to describe their social and health-related characteristics and the obstacles to access to care, with the goal of informing the public authorities and European institutions and bringing about positive changes. Materials and Methods A cross-sectional analysis of routine data collected from 23,341 patients who availed themselves of the DOW’s services in 26 cities in 11 countries in 2014 (Belgium, Canada, France, Germany Greece, the Netherlands, Spain, Sweden, Switzerland, Turkey and United Kingdom). . Of them, 652 were minors, and, 282 of them in 9 countries were asked about their immunization status. The MdM medical teams considered a minor vaccinated only upon presentation of his/her vaccination record. Results Only 43.3% of the minors seen at the MdM clinics had been vaccinated against tetanus, although 15.0% more had “probably” been vaccinated against it. This rate was even lower for whooping cough (41.0%), hepatitis B (40.0%) and MMR (35.8%). In addition, 40% of the patients had no idea where to go to get vaccinated. Discussion The analysis of the data collected from the children with multiple social vulnerabilities (especially, children of severely disadvantaged immigrants), together with an examination of the current national legislation, shows the extent to which these children’s basic rights are still ignored in our countries. More than half of the children seen in our facilities are not protected against tetanus, whooping cough, MMR or hepatitis (with a risk of being excluded from the school system, where such vaccinations are a mandatory prerequisite). In 5 of the 11 countries, legal obstacles to vaccination are one of the main barriers, and in all the countries, there is a glaring lack of information on access to vaccinations. Key messages More than half of the children seen in our facilities are not protected against tetanus, whooping cough, MMR or hepatitis In 5 of the 11 countries, legal obstacles to vaccination are one of the main barriers, and in all the countries, there is a glaring lack of information on access to vaccinations
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".