Estimation of the vaccination coverage before and after the warning about a quadrivalent vaccine against mumps, measles, rubella and varicella
Poster: 26th European Congress of Clinical Microbiology and Infectious Diseases 9.-12. April 2016; Amsterdam- Niederlande
Background: In 2010, the World Health Assembly targeted the eradication of measles to be achieved in 2015. Consequently, the German Standing Committee on Vaccinations (STIKO) recommends a two-dose schedule against mumps, measles, rubella and varicella. In September 2011, the German Standing Committee on Vaccinations (STIKO) changed their recommendation regarding the mumps-measles-rubella-varicella vaccination (MMRV) as a more than 2-fold significantly elevated relative risk of febrile convulsions in children occurred. Therefore, a concomitant but separate first dose vaccination for MMR and V was recommended since September 2011. The aim of our study was to compare the immunization rates against MMRV of two years old children in Germany before and after the STIKO-intervention in September 2011. Methods: We recorded the immunization statuses of children born between 09/2008 and 08/2012 in 35 selected doctor's surgeries in Germany who used the electronic vaccination scheduling program “Impf-doc”. The stratification of the selected surgeries was done by Nielsen region, town size and practice size. The data were anonymized by the software, encrypted for electronic transmission and recorded during regular practice hours. For better comparability, the age values were partially adjusted in the analysis by looking at the vaccination status at the end of the 24th months. Results: We analysed data of 28.982 children. After the STIKO intervention, the percentage of the MMRV vaccine was reduced to approximately 25% of the original value. The immunization rates did not decrease. Missing vaccinations were completed largely within the first 24 months of life. Most of the unvaccinated children were vaccinated later. The decrease of vaccinations against varicella about 1% was not significant. Conclusion: The increase of unvaccinated children was not significant, but the vaccination-related behaviour of the doctors was striking. The application of the quadrivalent vaccine declined clearly and was replaced by the concomitant but separate application of MMR + V. A positive influence of the electronic vaccination scheduling program “Impf-doc” on the immunization rates can be assumed. As the overall benefit-risk balance for the combined MMRV immunization is positive, the separate administration MMR+V vaccination may be a helpful option to overcome the parents' refusal of the MMRV injection and to improve the immunization rates in general.