Abstract
Whereas immunization coverage has been repeatedly assessed in the Swiss population, little is known about the timely administration of universally recommended immunizations in Switzerland and elsewhere. The goal of this study was to determine compliance with official standard immunization recommendations in pre-school and school-aged children in Basel, Switzerland, focusing on coverage rates and timely administration. Of a cohort of children entering kindergarten and third-grade primary school in Basel in 2001, 310 and 310, respectively, were identified in proportion to the overall age-appropriate populations in the four city districts. Foreign-born children were excluded. The data were extracted from immunization records provided voluntarily by parents. Coverage for three doses of diphtheria, tetanus, and poliomyelitis vaccines was >95% and <90% for pertussis and Hib. The rates of age-appropriate booster doses were significantly lower, especially for pertussis and Hib (<60%). Cumulative coverage for measles, mumps, and rubella (MMR) was <90% for the first dose and 33% for the second dose by 10 years of age. All immunizations were administered with significant delays. Coverage for the first three doses of DTP combination vaccines did not reach 90% before 1 year of age and, for the first dose of MMR, a plateau just below 80% was not reached before 3 years of age. Delayed administration of immunizations in childhood, as well as complete lack of booster doses in a significant fraction of children, with important implications for public health have been discovered in this study. This may lead to fatal disease in individuals, epidemics in the community, and threatens national and international targets of disease elimination, such as measles and congenital rubella syndrome.
Similar content being viewed by others
Abbreviations
- DTPa:
-
Diphtheria, tetanus, acellular pertussis component
- IPV:
-
Inactivated poliomyelitis vaccine
- OPV:
-
Oral poliomyelitis vaccine
- Hib:
-
Haemophilus influenzae type b
- MMR:
-
Measles, mumps, rubella
- HBV:
-
Hepatitis B vaccine
References
Bobo JK, Gale JL, Thapa PB, Wassilak SG (1993) Risk factors for delayed immunization in a random sample of 1163 children from Oregon and Washington. Pediatrics 91:308–314
Briss PA, Rodewald LE, Hinman AR, Shefer AM, Strikas RA, Bernier RR, Carande-Kulis VG, Yusuf HR, Ndiaye SM, Williams SM (2000) Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults. The Task Force on Community Preventive Services. Am J Prev Med 18(Suppl):97–140
CDSC (2000) COVER programme: October to December 1999 vaccination coverage statistics for children up to 5 years of age in the United Kingdom. Commun Dis Rep CDR Wkly 10:109–110
Dombkowski KJ, Lantz PM, Freed GL (2004) Risk factors for delay in age-appropriate vaccination. Public Health Rep 119:144–155
Dominguez SR, Parrott JS, Lauderdale DS, Daum RS (2004) On-time immunization rates among children who enter Chicago public schools. Pediatrics 114:e741–e747
Grimprel E, Baron S, Levy-Bruhl D, Garnier JM, N'jamkepo E, Guiso N, Begue P (1999) Influence of vaccination coverage on pertussis transmission in France. Lancet 354:1699–1700
Heininger U, Stehr K, Cherry JD (1992) Serious pertussis overlooked in infants. Eur J Pediatr 151:342–343
Laubereau B, Hermann M, Weil J, Schmitt HJ, von Kries R (1999) Durchimpfungsraten bei Kindern in Deutschland 1999. Monschr Kinderheilkd 149:367–372
Li J, Taylor B (1993) Factors affecting uptake of measles, mumps, and rubella immunisation. BMJ 307:168–171
Luman ET, Barker LE, Shaw KM, McCauley MM, Buehler JW, Pickering LK (2005) Timeliness of childhood vaccinations in the United States: days undervaccinated and number of vaccines delayed. JAMA 293:1204–1211
Matter HC (1999) Pertussis surveillance in Switzerland, 1992 to 1997—a large epidemic in 1994. What next? Euro Surveill 4:130–133
Maurer AM, Muhlemann K, Seiler AJ (2001) Vaccination of young children, at school entrance and completion in the Bern canton 1998 (in German). Schweiz Rundsch Med Prax 90:1676–1684
Paget JW, Zimmermann H, Vorkauf H (2000) A national measles epidemic in Switzerland in 1997: consequences for the elimination of measles by the year 2007. Euro Surveill 5:17–20
Roth-Kleiner M, Gnehm HE (1997) MMR, diphtheria-tetanus and polio vaccination of students in Aargau. Schweiz Rundsch Med Prax 86:1934–1937
Schaffer SJ, Szilagyi PG (1995) Immunization status and birth order. Arch Pediatr Adolesc Med 149:792–797
Siegrist CA (2005) Vaccinology update 2004 (in French). Rev Med Suisse 1:79–82
Szilagyi PG, Rodewald LE, Humiston SG, Raubertas RF, Cove LA, Doane CB, Lind PH, Tobin MS, Roghmann KJ, Hall CB (1993) Missed opportunities for childhood vaccinations in office practices and the effect on vaccination status. Pediatrics 91:1–7. Erratum in: Pediatrics 91:545
Szilagyi PG, Rodewald LE (1996) Missed opportunities for immunizations: a review of the evidence. J Public Health Manag Pract 2:18–25
von Kries R, Bohm O, Windfuhr A (1997) Haemophilus influenzae b-vaccination: the urgency for timely vaccination. Eur J Pediatr 156:282–287
Wendelboe AM, Van Rie A, Salmaso S, Englund JA (2005) Duration of immunity against pertussis after natural infection or vaccination. Pediatr Infect Dis J 24:S58–S61
World Health Organization (2005) Progress towards elimination of measles and prevention of congenital rubella infection in the WHO European Region, 1990–2004. Wkly Epidemiol Rec 80:66–71
Acknowledgements
We are grateful to Dr. Iris Meier, School Health Service of the Canton of Basel, Switzerland, for her assistance and support in conducting this survey. Further, the willingness of the parents who participated is gratefully acknowledged.
Author information
Authors and Affiliations
Corresponding author
Additional information
This work contains data from the medical thesis of Mirjam Zuberbühler at the Medical Faculty, University of Basel, Switzerland
Rights and permissions
About this article
Cite this article
Heininger, U., Zuberbühler, M. Immunization rates and timely administration in pre-school and school-aged children. Eur J Pediatr 165, 124–129 (2006). https://doi.org/10.1007/s00431-005-0014-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00431-005-0014-y