Vaccination safety update

Immunization rates at the school entry in 2012

BACKGROUND

The immunization rates for some diseases, including measles, were so low in Germany in recent years that endemic outbreaks occurred. A finely detailed geographic analysis of immunization rates is necessary for the identification of under-immunized areas.

METHODS

We addressed this question with the aid of regional and local data from school entrance examinations, which were made available to us by the health departments of the German federal states. These data are represented both in tabular form and with the aid of a geographical information system (GIS).

RESULTS

The immunization rates for tetanus, pertussis, and poliomyelitis were high throughout Germany (96.5%, 95.6%, and 95.2%, respectively). In contrast, major variation across regions was seen in immunization rates for hepatitis B (range: 53.5% to 99.1%) and measles (52.1% to 98.3%), with higher immunization rates in areas of the former East Germany. Low immunization rates were particularly evident in some areas in the states of Bavaria and Baden-Württemberg. In some parts of Saxony (a state in the former East Germany), the official immunization recommendations differ from those of the nationwide Standing Committee on Vaccination (STIKO); as a result, these areas had a mean measles immunization rate of only 66.7% among children entering school.

CONCLUSION

High immunization rates were found across Germany for tetanus, pertussis, and poliomyelitis, although the rates in some regions were lower than they should be. Stronger informational efforts must be undertaken to improve the public acceptance of immunization against hepatitis B and measles, so that these immunization rates can rise. For measles in particular, uniform nationwide recommendations might help increase the immunization rate.

Vaccination recommendations for Germany

BACKGROUND

Vaccination is an effective means of preventing infectious diseases. In Germany, the Standing Vaccination Committee at the Robert Koch Institute (Ständige Impfkommission, STIKO) issues recommendations on vaccination to prevent the occurrence and spread of infectious diseases in the nation's population.

METHODS

Selective literature review, including consideration of the current STIKO recommendations.

RESULTS

The annually updated vaccination calendar currently includes recommendations for vaccination against diphtheria, tetanus, pertussis, type b Haemophilus influenzae, hepatitis B, poliomyelitis, and pneumococci, beginning at the age of eight weeks. From the age of twelve months onward, children should be vaccinated against measles, mumps, rubella, varicella, and serogroup C meningococci. In later childhood and adolescence, booster vaccinations are recommended, in addition to the provision of any vaccinations that may have been missed. Girls aged 12 to 17 years should be vaccinated against human papilloma virus. Adults should have their tetanus and diphtheria vaccinations refreshed regularly, and their pertussis vaccination refreshed once; from age 60 onward, they should be vaccinated against pneumococci and influenza.

CONCLUSIONS

The vaccinations recommended by the STIKO are available to all German citizens free of charge and provide effective protection against infectious disease.

Vaccination status and health in children and adolescents: findings of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)

BACKGROUND

Whether unvaccinated children and adolescents differ from those vaccinated in terms of health is subject to some discussion.

METHOD

We evaluated data on diseases that are preventable by vaccination, infectious and atopic diseases, and vaccinations received that had been collected between 2003 and 2006 in a representative sample of 17 641 subjects aged 0 to 17 years in the framework of the German Health Interview and Examination Survey for Children and Adolescents (Kinder- und Jugendgesundheitssurvey, KiGGS).

RESULTS

Evaluable data on vaccinations were available for 13 453 subjects aged 1-17 years from non-immigrant families. 0.7% of them (95% confidence interval: 0.5%-0.9%) were not vaccinated. The lifetime prevalence of diseases preventable by vaccination was markedly higher in unvaccinated than in vaccinated subjects. Unvaccinated children aged 1-5 years had a median number of 3.3 (2.1-4.6) infectious diseases in the past year, compared to 4.2 (4.1-4.4) in vaccinated children. Among 11- to 17-year-olds, the corresponding figures were 1.9 (1.0-2.8) (unvaccinated) versus 2.2 (2.1-2.3) (vaccinated). The lifetime prevalence of at least one atopic disease among 1- to 5-year-olds was 12.6% (5.0%-28.3%) in unvaccinated children and 15.0% (13.6%-16.4%) in vaccinated children. In older children, atopy was more common, but its prevalence was not found to depend on vaccination status: among 6- to 10-year-olds, the prevalence figures were 30.1% (12.9%-55.8%) for unvaccinated children versus 24.4% (22.8%-26.0%) for vaccinated children, and the corresponding figures for 11- to 17-year-olds were 20.3% (10.1%-36.6%) versus 29.9% (28.4%-31.5%).

CONCLUSION

The prevalence of allergic diseases and non-specific infections in children and adolescents was not found to depend on vaccination status.