Progress toward Measles Elimination in Germany

Hellenbrand, Wiebke; Tischer, Annedore; Meyer, Christiane; Reiter, Sabine; Rasch, Gernot; Teichmann, Dieter; Santibanez, Sabine; Altmann, Doris; Claus, H.; Kramer, Michael H.

doi:10.1086/368046

Cited by 30 publications

(28 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This might reflect continuing adherence to different childhood vaccination policies before re-unification [15,19]. Immunization is voluntary in Germany now, but it was mandatory in the former German Democratic Republic.…”

Section: Measles-mumps-rubella (Mmr) Vaccinationmentioning

confidence: 99%

Heterogeneity in vaccination coverage explains the size and occurrence of measles epidemics in German surveillance data

2010

View full text Add to dashboard Cite

SUMMARYThe objective of this study was to characterize empirically the association between vaccination coverage and the size and occurrence of measles epidemics in Germany. In order to achieve this we analysed data routinely collected by the Robert Koch Institute, which comprise the weekly number of reported measles cases at all ages as well as estimates of vaccination coverage at the average age of entry into the school system. Coverage levels within each federal state of Germany are incorporated into a multivariate time-series model for infectious disease counts, which captures occasional outbreaks by means of an autoregressive component. The observed incidence pattern of measles for all ages is best described by using the log proportion of unvaccinated school starters in the autoregressive component of the model.

show abstract

Section: Measles-mumps-rubella (Mmr) Vaccinationmentioning

confidence: 99%

Heterogeneity in vaccination coverage explains the size and occurrence of measles epidemics in German surveillance data

2010

View full text Add to dashboard Cite

show abstract

“…18,[29][30][31] It therefore represents a significant threat to the World Health Organization's program to eliminate measles from the European region and may predict the persistent circulation of the measles virus and consecutive outbreaks. [15][16][17]32 Indeed, herd immunity is thought to succeed in the control of measles only when immunization levels are Ͼ93% to 95%. 33 The belief that immunization may be initiated "too early" is also a frequent parental concern fueled by theoretical issues such as immune overload.…”

Section: Immunization In Physicians' Childrenmentioning

confidence: 99%

“…This problem is illustrated best by the persistent insufficient vaccine coverage against measles leading to continual large outbreaks in several Western European countries including Switzerland. [14][15][16][17][18] Our study therefore aimed at interviewing physicians to evaluate how they have immunized, or would immunize, their own children and what kind of role models they provide to parents regarding immunization.…”

mentioning

confidence: 99%

How Do Physicians Immunize Their Own Children? Differences Among Pediatricians and Nonpediatricians

et al. 2005

View full text Add to dashboard Cite

ABSTRACT. Context. Immunization has an essential impact on public health worldwide. Numerous studies have shown the efficacy of different vaccines to protect individuals from various diseases. However, some parents choose not to vaccinate their children for reasons such as, among others, doubts regarding their usefulness, concerns over safety or efficacy, etc. Physicians are known to exert a direct influence on immunization rates by answering questions and clarifying misconceptions. Yet, it is unknown how they immunize their own children.Objective. We sought to assess how physicians interested in vaccination issues immunized, or would immunize, their own children.Design, Setting, and Participants. An 11-question, Webbased survey with a total of 102 discrete answers was sent to 2070 Swiss physicians in October 2004. All physicians were subscribers to a nonprofit, Web-based expert network (InfoVac, www.infovac.ch) that distributes monthly newsletters and answers question within 2 days on immunization issues. The InfoVac network reaches >95% of pediatricians in Switzerland but <20% of general practitioners. All responses were anonymous, and no identifier could be used to trace the participants of the survey. Questions were divided into 2 parts: (1) physicians who were parents were asked which vaccines they gave to their own children and at what age, and (2) all physicians were asked which vaccines they would give to their own child and at what age if they had a newborn child in 2004. Vaccines available in Switzerland at the time of the survey were offered as possible replies, and recommended vaccines were considered as those noted in the Swiss federal immunization schedule issued yearly. One question compared their immunization practice between their own children and their patients. Sociodemographics, qualifying year, membership in different professional groups, and their type of practice were also requested.Statistics. Standard descriptive statistics were used for sociodemographic characteristics. Univariate statistical analyses were performed for each variable to determine its relationship to the dependent variable, being a pediatrician or nonpediatrician. Logistic-regression analysis was used to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs), controlling for any statistically significant demographic variables that might function as confounders (gender, parenthood, workplace, year of diploma, and type of practice). For all statistical tests, differences were considered significant at P < .05.Main Outcome Measure. We performed a comparison of past and projected immunization rates in the children of pediatricians and nonpediatricians.Results. One thousand seventeen valid questionnaires were received (response rate: 49.1%; pediatricians: 53.3%). Nine hundred fifteen physicians (90%) had >1 child. All physicians reported immunizing children in their practice. Pediatricians were more likely to be women and to work in private practice than nonpediatricians but less likely to belong to a sel...

show abstract

“…However, the information provided by sentinel systems is usually considered to be timelier and more complete, due to better compliance of voluntarily reporting physicians [6]. On the other hand, the mandatory notification systems often shows significant underreporting, with incidence rates several times lower than in sentinel systems [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

A 5-year comparison of performance of sentinel and mandatory notification surveillance systems for measles in Switzerland

2007

View full text Add to dashboard Cite

A sensitive, specific and timely surveillance is necessary to monitor progress towards measles elimination. We evaluated the performance of sentinel and mandatory-based surveillance systems for measles in Switzerland during a 5-year period by comparing 145 sentinel and 740 mandatory notified cases. The higher proportion of physicians who reported at least one case per year in the sentinel system suggests underreporting in the recently introduced mandatory surveillance for measles. Accordingly, the latter reported 2-36-fold lower estimates for incidence rates than the sentinel surveillance. However, these estimates were only 0.6-12-fold lower when we considered confirmed cases alone, which indicates a higher specificity of the mandatory surveillance system. In contrast, the sentinel network, which covers 3.5% of all outpatient consultations, detected only weakly and late a major national measles epidemic in 2003 and completely missed 2 of 10 cantonal outbreaks. Despite its better timeliness and greater sensitivity in case detection, the sentinel system, in the current situation of low incidence, is insufficient to perform measles control and to monitor progress towards elimination.

show abstract

Progress toward Measles Elimination in Germany

Cited by 30 publications

References 9 publications

Heterogeneity in vaccination coverage explains the size and occurrence of measles epidemics in German surveillance data

Heterogeneity in vaccination coverage explains the size and occurrence of measles epidemics in German surveillance data

How Do Physicians Immunize Their Own Children? Differences Among Pediatricians and Nonpediatricians

A 5-year comparison of performance of sentinel and mandatory notification surveillance systems for measles in Switzerland

Contact Info

Product

Resources

About