Vaccination rate and adherence of tick-borne encephalitis vaccination in Germany

BACKGROUND

Tick-borne encephalitis (TBE) is an arboviral infection of the central nervous system. As there is no causal treatment of TBE, disease prevention by vaccination is especially important. Immunization consists of a three-dose primary vaccination schedule, followed by regular booster doses. In Germany, the Standing Committee on Vaccination (STIKO) at the Robert Koch-Institute recommends TBE vaccination for all those at high risk of contracting TBE. This includes individuals living in, traveling to and/or working in risk areas, and being exposed to ticks. To our knowledge, there are currently no reliable data on TBE vaccination rates in Germany available.

METHODS

This retrospective cohort study based on anonymized German health claims data was conducted to determine vaccination rates of TBE primary immunization in 2012 to 2015 by federal state, compliance with the vaccination schedule, and TBE vaccination uptake for the 2011 birth cohort. Vaccination protection rates for each federal state were simulated based on a compartmental model.

RESULTS

Vaccination rates of an initiated primary immunization ranged from about 3% in the southern federal states to <1% in the northern federal states. Across all federal states, compliance with the vaccination schedule decreased with each subsequent vaccination. Slightly higher TBE vaccination uptake was determined in the 2011 birth cohort, as compared to the German school entry health examination statistics in 2017. Simulated vaccination protection rates for each federal state ranged from 10% in Hamburg to 51% in Baden-Wuerttemberg.

CONCLUSIONS

While there was an overall low vaccination uptake and a discrepancy between areas of high vs. low TBE risk, this study also indicates a concerning decline in vaccination compliance. Vaccinating physicians should address the importance of adherence upon initiation of TBE vaccination.

Exciton-exciton annihilation in a molecular trimer: Wave packet dynamics and 2D spectroscopy

We theoretically study the exciton-exciton annihilation (EEA) in a molecular trimer MMM. The system is treated within a model of electronic states, and the coupling to a bath is incorporated using the quantum jump method. Two situations of initial excitation are compared. In the first one, a two-photon process populates configurations M^*M^*M and MM^*M^* so that two excitons reside on neighboring monomers M. Then, EEA can immediately proceed. In contrast, if the trimer initially is in the local configuration M^*MM^*, exciton diffusion must occur before the annihilation process can take place. For the trimer, this excitonic motion takes place on a very short time scale. In both cases, wave packets are prepared which show a different quantum dynamics where the latter depends on the couplings and decay rates. It is documented how fifth-order coherent two-dimensional spectroscopy can be used to directly map the EEA as a function of time.

A wave packet picture of exciton-exciton annihilation: Molecular dimer dynamics

The usual view of exciton-exciton annihilation (EEA) processes in molecular aggregates is based on locally excited states of the monomer units. However, the corresponding localized configurations can only be assumed if the system is in a coherent superposition of eigenstates, i.e., a wave packet. We study a molecular dimer and focus on the characterization of EEA by a wave packet motion induced in the system by ultrashort pulse excitation. Here, coherences that appear are destroyed by dissipation processes. We discuss the influence of interband and intraband relaxation on the dynamics. The states that participate in the annihilation process are directly accessible by fifth-order optical two-dimensional spectroscopy. Such spectra are calculated, and spectral features are related to the annihilation process.