Introduction

COVID-19 vaccination coverage among children in France is low compared with adults. This study describes COVID-19 vaccine uptake in children aged 5–11 years and identifies its determinants.

Method

Using data from the COVID-19 vaccine information system (VAC-SI) chained to the French National Health Data System (SNDS, including the Mother-Child EPI-MERES register), this cohort study included children aged 5–11 years in 2021 who had received at least one dose of a COVID-19 vaccine between 1 January 2021 and 15 November 2023. The determinants were identified using adjusted logistic regression.

Results

Our results showed that 320,737 children aged 5–11 years (80% aged 8 and over; 48% female) had received a COVID-19 vaccine, representing only 5.3% of this population. Among children at risk of severe disease, 7.8% were vaccinated. Factors positively associated with vaccination were higher age, presence of maternal comorbidities, residence in the west of France vs Pays de la Loire (Normandy adjusted odds ratio [aOR]=1.12 [95% CI 1.10–1.14], Brittany aOR=1.04 [1.02–1.07]) and the mother being vaccinated (aOR=16.60 [16.04–17.17]). Conversely, living in an area with a low socioeconomic level (deprivation index, Q5 vs Q1: aOR=0.62 [0.61–0.63]) and in the southeast of France (Occitania aOR=0.48 [0.47-0.49], Provence-Alpes-Côte d’Azur aOR=0.37 [0.36–0.38]) were negatively associated with vaccination among children.

Conclusion

Vaccination against COVID-19 in children aged 5–11 years remains very low in France, with one in thirteen at-risk children vaccinated and one in twenty vaccinated overall. This low vaccination rate is also associated with a low socio-economic level and living in the southeast of mainland France.