, Volume 44, Issue 6, pp 781–787 | Cite as

Measles, mumps, rubella, and varicella seroprevalence in refugees in Germany in 2015

  • Alexandra JablonkaEmail author
  • Christine Happle
  • Ulrike Grote
  • Benjamin Thomas Schleenvoigt
  • Annika Hampel
  • Christian Dopfer
  • Gesine Hansen
  • Reinhold Ernst Schmidt
  • Georg M. N. Behrens
Brief Report



The current extent of migration poses emerging socio–economic and humanitarian challenges. Little is known on vaccination rates in migrants entering Europe, and the implementation of guidelines for serological testing and vaccination of refugees are pending.


We conducted seroprevalence analyses for measles, mumps, rubella and varicella (MMRV) in 678 refugees coming to Germany during the current crisis.


The mean age of refugees was 28.8±11.4 years, and 76.1 % of subjects were male. Overall, IgG seronegativity was 7.4 % (95 % CI 5.5-9.6) for measles, 10.2 % (95 % CI 8.0-12.5) for mumps, 2.2 % (95 % CI 1.2-3.4) for rubella, and 3.3 % (95 % CI 1.9-4.9) for varicella. Seropositivity rates were age-dependent with considerably low values in children. For example, overall MMR immunity was 90.9 % (95 % CI 88.8-93.1), but only 73.1 % of minor aged refugees displayed complete seroprevalence against all three diseases, and only 68.9 % of children and adolescents were completely MMRV immune.


Our initial data set suggests overall satisfactory MMRV immunity in adult migrants coming to Europe, but the observed low MMRV seroprevalences in refugee children support thorough and prompt vaccination of young migrants entering Europe. Taken together, our data set underlines the urgent need to implement and validate vaccination guidelines for refugee care in the current crisis.


Vaccination Refugees Measles Mumps Rubella Varicella 



European Union


Immunoglobulin G




Vaccine-preventable diseases


Compliance with ethical standards

Conflict of interest

None to specify.

Supplementary material

15010_2016_926_MOESM1_ESM.docx (151 kb)
Supplementary material 1 (DOCX 151 kb)


  1. 1.
    Cousins S. Syrian crisis: health experts say more can be done. Lancet. 2015;385:931–4.CrossRefPubMedGoogle Scholar
  2. 2.
    Lam E, McCarthy A, Brennan M. Vaccine-preventable diseases in humanitarian emergencies among refugee and internally-displaced populations. Hum vaccines immunother. 2015;11:2627–36.CrossRefGoogle Scholar
  3. 3.
    Jakab Z. Population movement is a challenge for refugees and migrants as well as for the receiving population. 2015. Accessed 18 July 2016.
  4. 4.
    WHO. Elimination Measles and Rubella - Framework for the elimination process in the WHO European Region. 2014. Accessed 15 July 2016.
  5. 5.
    Poethko-Muller C, Mankertz A. Seroprevalence of measles-, mumps- and rubella-specific IgG antibodies in German children and adolescents and predictors for seronegativity. PLoS One. 2012;7:e42867.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Ständige Impfkommission (STIKO) am Robert Koch-Institut. Empfehlungen/Stand: August 2015. Epidemiol Bull RKI. 2015;34:327–62.Google Scholar
  7. 7.
  8. 8.
    Robert Koch-Institut. Konzept zur Umsetzung frühzeitiger Impfungen bei Asylsuchenden nach Ankunft in Deutschland. 2015. Epidemiol Bull RKI. 2016;41:439–44.Google Scholar
  9. 9.
    WHO-UNHCR-UNICEF. Joint technical guidance: general principles of vaccination of refugees, asylum-seekers and migrants in the WHO European region. 2015.Google Scholar
  10. 10.
    Takla A, Barth A, Siedler A, Stocker P, Wichmann O, Delere Y. Measles outbreak in an asylum-seekers’ shelter in Germany: comparison of the implemented with a hypothetical containment strategy. Epidemiol Infect. 2012;140:1589–98.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Alexandra Jablonka
    • 1
    • 2
    Email author
  • Christine Happle
    • 3
    • 4
  • Ulrike Grote
    • 5
  • Benjamin Thomas Schleenvoigt
    • 6
  • Annika Hampel
    • 7
  • Christian Dopfer
    • 3
    • 4
  • Gesine Hansen
    • 3
    • 4
  • Reinhold Ernst Schmidt
    • 1
    • 2
  • Georg M. N. Behrens
    • 1
    • 2
    • 8
  1. 1.Department of Clinical Immunology and RheumatologyHannover Medical SchoolHannoverGermany
  2. 2.German Center for Infection ResearchHannover-BraunschweigGermany
  3. 3.Department of Pediatrics, Neonatology and AllergologyHannover Medical SchoolHannoverGermany
  4. 4.German Center for Lung Research, BREATHHannoverGermany
  5. 5.Department of Hematology and OncologyHannover Medical SchoolHannoverGermany
  6. 6.Center for Infectious Diseases and Infection ControlJena University HospitalJenaGermany
  7. 7.Department for Anaesthesiology and Surgical Intensive Care MedicineHospital WolfsburgWolfsburgGermany
  8. 8.Niedersachsen Network on NeuroinfectiologyHannoverGermany

Personalised recommendations