Skip to main content
SpringerLink
Log in

Fully vaccinated children are rare: Immunization coverage and seroprevalence in Austrian school children

  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

Vaccination coverage for vaccine-preventable diseases in Austria as well as in many Central European countries has been reported to be too low to eradicate such diseases and prevent further outbreaks. Austria lacks an adequate surveillance system to monitor prevalence of the diseases, the vaccination coverage and seroconversion. School children aged 10–14 years (n = 1077) were recruited in all four schools in the city of Schwaz, Austria, to present their vaccination documents and to give blood for serological testing (diphtheria, pertussis, measles, mumps, rubella, varicella). All participants received a report with a personal guideline for (re-) vaccination. Overall vaccination coverage was 86.4% for measles, 85.5% for mumps and 35.0% for rubella. Tetanus vaccination coverage was 98.4% for the first, 97.8% for the second and 96.7% for the third dose, while 55.4% of the study subjects received the recommended two booster injections. For diphtheria the corresponding vaccination coverage was found to be almost identical. Pertussis coverage was lower in general (first dose: 90.9%; second dose: 89.0%; third dose: 86.5%). Oral poliomyelitis vaccination showed a coverage of 98.6, 96.5, 95.3%, with 78.7% receiving the fourth dose. Overall 38.7% were classified as fully vaccinated. Seropositivity for measles was found in 90.4%, for mumps in 61.8%, for rubella in 82.3%, for diphtheria in 65.8%, for pertussis in 35.6% and for varicella in 95.0%. In summary, fully vaccinated children are rare and intensive public health efforts will be necessary to reach higher levels of immunity and prevent further outbreaks.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Peltola H, et al. The elimination ofindigenous measles, mumps, and rubella from Finland by a 12-year, twodose vaccination program (see comments). N Engl J Med 1994; 331: 1397–1402.

    Google Scholar 

  2. Galindo MA, et al. Eradication of measles in Cuba (published erratum appears in Rev Panam Salud Publica 1998 Nov;4(5):345). Rev Panam Salud Publica 1998; 4: 171–177.

    Google Scholar 

  3. Osborne K, Weinberg J, Miller E. The European seroepidemiology network. Eurosurveillance Wkly Vol. 2(4): April 1997.

  4. Helwig H, et al. Childhood immunisation in the European Union. Confederation of European Specialists in Paediatrics (CESP). Eur J Pediatr 1998; 157: 676–680.

    Google Scholar 

  5. Guerin N, Roure C. Immunization coverage in the European Union. Eurosurveillance Wkly Vol. 2(1): January 1997.

  6. Weithaler K, et al. EPI-Immunization coverage survey in Innsbruck/Austria. Weekly Epidemiological Record No. 25, June 1987.

  7. Stronegger WJ, Freidl W. Die Masern-(MMR)-Impfquote bei Haupt-und AHS/Unterstufe-Schulkindern in der Steiermark. Mitteilungen der österreichischen Sanitätsverwaltung 1/1998.

  8. Haidinger G, Haschke F, Vutuc C. Vaccination status and sociodemographic variables in Viennese public school students. Soz Praventivmed 1996; 41: 194–199.

    Google Scholar 

  9. Strategies to sustain success in childhood immunizations. The National Vaccine Advisory Committee. JAMA 1999; 282: 363–370.

  10. Hersh BS, Tambini G, Nogueira AC, Carrasco P, de Quadros CA. Review ofregional measles surveillance data in the Americas, 1996-99. Lancet 2000; 355: 1943–1948.

    Google Scholar 

  11. Measles outbreak - Netherlands, April 1999-January 2000. MMWR Morb Mortal Wkly Rep 2000; 49: 299–303.

  12. Mary M, et al. Six years of public health surveillance ofmeasles in France. Int J Epidemiol 1992; 21: 163–168.

    Google Scholar 

  13. Gangarosa EJ, et al. Impact ofanti-vaccine movements on pertussis control: The untold story. Lancet 1998; 351: 356–361.

    Google Scholar 

  14. Miyamura K, Nishio S, Ito A, Murata R, Kono R. Micro cell culture method for determination of diphtheria toxin and antitoxin titres using VERO cells. I. Studies on factors affecting the toxin and antitoxin titration. J Biol Stand 1974; 2: 189–201.

    Google Scholar 

  15. Stohrer-Draxl P, et al. Measles, mumps and rubella: Vaccination rate and seroprevalence in 8th grade students of8 different sites in Switzerland 1995/96. Schweiz Rundsch Med Prax 1999; 88: 1069–1077.

    Google Scholar 

  16. Bottiger M, Gustavsson O, Svensson A. Immunity to tetanus, diphtheria and poliomyelitis in the adult population of Sweden in 1991. Int J Epidemiol 1998; 27: 916–925.

    Google Scholar 

  17. Robert Koch Institut. Zur Überprüfung des MMR-Impstatus des Landes Brandenburg 1997/1998. Epidemiologisches Bull 1999; 23: 174–175.

    Google Scholar 

  18. Robert Koch Institut. Erhebung von Impfraten zum Zeitpunkt der Einschulung. Epidemiologisches Bull 1999; 23: 171–173.

    Google Scholar 

  19. Robert Koch Institut. Impfstatus und Impfempfehlungen in Hauptschulen des Landkreises München. Epidemiologisches Bull 1998; 50: 355–356.

    Google Scholar 

  20. Svensson A, Bottiger M, Gustavsson O. Immunity in the Swedish population: Diphtheria, tetanus and poliomyelitis. Int J Epidemiol 1998; 27: 909–915.

    Google Scholar 

  21. Bolton P, Holt E, Ross A, Hughart N, Guyer B. Estimating vaccination coverage using parental recall, vaccination cards, and medical records. Public Health 1998; 113: 521–526.

    Google Scholar 

  22. Salmaso S, Rota MC, Ciofi Degli Atti ML, Tozzi AE, Kreidl P. Infant immunization coverage in Italy; Estimates by simultaneous EPI cluster surveys of regions. ICONA Study Group. Bull World Health Organ 1999; 77: 843–851.

    Google Scholar 

  23. Vitek CR, et al. Risk of diphtheria among schoolchildren in the Russian Federation in relation to time since last vaccination. Lancet 1999; 353: 355–358.

    Google Scholar 

  24. Markina SS, Maksimova NM, Vitek CR, Bogatyreva EY, Monisov AA. Diphtheria in the Russian Federation in the 1990s. J Infect Dis 2000; 181(Suppl 1): S27–S34.

    Google Scholar 

  25. Progress toward the global interruption ofwild poliovirus type 2 transmission, 1999. MMWR Morb Mortal Wkly Rep 1999; 48: 736–738, 747.

  26. Leandro Liberato SV, et al. Child vaccination: The coverage, knowledge and attitudes ofthe population. A study in a health area. An Esp Pediatr 1996; 44: 464–468.

    Google Scholar 

  27. De Spiegelaere M, Dramaix M, Hennart P. Social inequalities and prevention: Vaccination status ofadolescents. Rev Epidemiol Sante Publique 1996; 44: 228–236.

    Google Scholar 

  28. Mossong J, et al. Modeling the impact of subclinical measles transmission in vaccinated populations with waning immunity. Am J Epidemiol 1999; 150: 1238–1249.

    Google Scholar 

  29. Whittle HC, et al. Effect ofsubclinical infection on maintaining immunity against measles in vaccinated children in West Africa. Lancet 1999; 353: 98–102.

    Google Scholar 

  30. Davidkin I, Valle M. Vaccine-induced measles virus antibodies after two doses of combined measles, mumps and rubella vaccine: A 12-year follow-up in two cohorts. Vaccine 1998; 16: 2052–2057.

    Google Scholar 

  31. Paunio M, et al. Twice vaccinated recipients are better protected against epidemic measles than are single dose recipients ofmeasles containing vaccine. J Epidemiol Commun Health 1999; 53: 173–178.

    Google Scholar 

  32. Galazka A, Kraigher A, Robertson SE. Wide-spread inflammation of the parotid glands (mumps): An underestimated disease. II. Development, use, efficacy and safety of mumps vaccines. Przegl Epidemiol 1998; 52: 401–412.

    Google Scholar 

  33. Goh KT. Resurgence of mumps in Singapore caused by the Rubini mumps virus vaccine strain (letter). Lancet 1999; 354: 1355–1356.

    Google Scholar 

  34. Cheek JE, Baron R, Atlas H, Wilson DL, Crider RD Jr. Mumps outbreak in a highly vaccinated school population. Evidence for large-scale vaccination failure. Arch Pediatr Adolesc Med 1995; 149: 774–778.

    Google Scholar 

  35. Matter HC, Cloetta J, Zimmermann H. Measles, mumps, and rubella: Monitoring in Switzerland through a sentinel network, 1986-94. Sentinella Arbeits gemeinschaft. J Epidemiol Commun Health 1995; 49(Suppl) 1: 4–8.

    Google Scholar 

  36. Condorelli F, et al. Use ofa microquantity enzyme immunoassay in a large-scale study ofmeasles, mumps and rubella immunity in Italy. Eur J Clin Microbiol Infect Dis 1998; 17: 49–52.

    Google Scholar 

  37. Strohle A, Germann D. Mumps vaccines: virological basis. Soz Praventivmed 1995; 40: 102–109.

    Google Scholar 

  38. van Boven M, de Melker HE, Schellekens JF, Kretzschmar M. Waning immunity and sub-clinical infection in an epidemic model: Implications for pertussis in The Netherlands. Math Biosci 2000; 164: 161–182.

    Google Scholar 

  39. Hethcote HW. Simulations ofpertussis epidemiology in the United States: Effects ofadult booster vaccinations. Math Biosci 1999; 158: 47–73.

    Google Scholar 

  40. Cherry JD. Epidemiological, clinical, and laboratory aspects ofpertussis in adults. Clin Infect Dis 1999; 28(Suppl 2): S112–S117.

    Google Scholar 

  41. van Boven M, de Melker HE, Schellekens JF, Kretzschmar M. Waning immunity and sub-clinical infection in an epidemic model: Implications for pertussis in The Netherlands. Math Biosci 2000; 164: 161–182.

    Google Scholar 

  42. Mertens PL, Stals FS, Schellekens JF, Houben AW, Huisman J. An epidemic ofpertussis among elderly people in a religious institution in The Netherlands. Eur J Clin Microbiol Infect Dis 1999; 18: 242–247.

    Google Scholar 

  43. Garcia-Corbeira P, Dal Re R, Aguilar L, Garcia-de-Lomas J. Seroepidemiology ofBordetella pertussis infections in the Spanish population: A cross-sectional study. Vaccine 2000; 18: 2173–2176.

    Google Scholar 

  44. Garcia-Corbeira P, Dal Re R, Garcia-de-Lomas J, Aguilar L. Low prevalence ofdiphtheria immunity in the Spanish population: Results ofa cross-sectional study. Vaccine 1999; 17: 1978–1982.

    Google Scholar 

  45. Ballereau F, et al. A multicentre serosurvey on diphtheria immunity in a French population of1004 subjects. Eur J Epidemiol 1998; 14: 499–503.

    Google Scholar 

  46. Hasselhorn HM, Nubling M, Tiller FW, Hofmann F. Factors influencing immunity against diphtheria in adults. Vaccine 1998; 16: 70–75.

    Google Scholar 

  47. Coudeville L, Paree F, Lebrun T, Sailly J. The value of varicella vaccination in healthy children: Cost-benefit analysis of the situation in France. Vaccine 1999; 17: 142–151.

    Google Scholar 

  48. Lee MS, Lee LL, Chen HY, Wu YC, Horng CB. Post mass-immunization measles outbreak in Taoyuan county, Taiwan: Dynamics oftransmission, vaccine effectiveness, and herd immunity. Int J Infect Dis 1999; 3: 64–69.

    Google Scholar 

  49. Global measles control and regional elimination, 1998-1999. MMWR Morb Mortal Wkly Rep 1999; 48: 1124–1130.

  50. Kessler T. Vaccination status ofchildren in the Vienna area (author's transl). Wien Klin Wochenschr 1978; 90: 835–838.

    Google Scholar 

  51. Villalbi JR, et al. Vaccinal coverage at 2 years ofage in a socially disadvantaged urban area. Aten Primaria 1992; 9: 154–156.

    Google Scholar 

  52. Marks JS, Halpin TJ, Irvin JJ, Johnson DA, Keller JR. Risk factors associated with failure to receive vaccinations. Pediatrics 1979; 64: 304–309.

    Google Scholar 

  53. Ziemer B, Blank K, Hennig R, Vaccination status and implementation ofrecommendations for vaccination with special reference to measles-mumps-rubella vaccination. 1995 program for school entrance. Gesundheitswesen 1998; 60: 297–300.

    Google Scholar 

  54. Kunze M. The contribution of social medicine to vaccination in Austria. Wien Med Wochenschr 1998; 148: 191–197.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Public Health, Department of Hygiene and Social Medicine, Innsbruck University, Austria

    Markus Ringler, Johannes Möst & Kurt Weithaler

  2. Department of Internal Medicine, Schwaz District Hospital, Austria

    Markus Ringler

  3. Department of Biostatistics and Documentation, Innsbruck University, Austria

    Georg Göbel

Authors
  1. Markus Ringler
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Georg Göbel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Johannes Möst
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kurt Weithaler
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ringler, M., Göbel, G., Möst, J. et al. Fully vaccinated children are rare: Immunization coverage and seroprevalence in Austrian school children. Eur J Epidemiol 18, 161–170 (2003). https://doi.org/10.1023/A:1023038705835

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1023038705835

Search

Navigation