NECESSITY OF A CONTINUED ADAPTATION FOR V ACCINATIONS AGAINST MENINGOCOCCAL MENINGITIS, TYPHOID AND VIRAL HEPATITIS-A IN THE ARMED-FORCES

The history of military medecine has always been closely linked with t hat of vaccinations. Doctors of Armed Forces, doctors of collectivitie s, have contributed to vaccination progresses in large amounts. But ev olutions are often rapid here: epidemiological modifications, improvem ents in the existing vaccines or creation of new vaccines, diversifica tion of military specificities. Three recent modifications in the vacc ination schedule of the Armed Forces show this necessary adaptation: s ystematization of the meningococcal A + C vaccination during the incor poration, because of the modification of the disease's epidemiological profile; increase of the frequency in serogroup C with a mortality in crease (9 cases of death out of 10 observed between 1991 and 1992); ca ncellation of antityphoid vaccination for recruits serving in home cou ntry. Indeed the disease has become rare in France, and this is often due to imported cases (3 cases in the Armed Forces in 1992); introduct ion in 1994 of vaccination against viral hepatitis A, systematic under the age of 25 years and after a serological selection above for servi cemen having to serve overseas or for outside operations. These 3 exam ples show the necessity to have updated and adaptable vaccination sche dules.