Skip to main content

Advertisement

SpringerLink
Log in

Compliance with recommended immunizations in adolescents

  • Original Paper
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Introduction

Little is known about the completeness and timely administration of recommended standard immunizations in Germany. The goal of this study was to determine compliance with official standard immunization recommendations in adolescents attending secondary schools in the city of Erlangen, Germany.

Methods

Adolescents who were attending 5th grade (at approximately 11 years of age), 8th grade (14 years), or 10th and 11th grade (16–17 years) classes at any of the 13 of 14 schools that had agreed to participate were eligible to be enrolled.

Results

While coverage for the primary series of diphtheria, tetanus and poliomyelitis immunizations was satisfactory (98%), coverage for measles-mumps-rubella immunizations (dose 1: 89–96%; dose 2: 60–76%) and hepatitis B (doses 1–3: 61%) was suboptimal. Of note, 39% of students had not received any immunization against pertussis. Completion of immunization series generally was significantly delayed. Furthermore, rates for recommended booster doses in adolescence were disappointingly low with 21% for tetanus component vaccines and <10% for the fifth dose of pertussis.

Conclusions

Significant immunization gaps for all recommended standard immunizations in adolescents were detected. This puts individuals at risk for serious vaccine-preventable diseases, contributes to suboptimal herd immunity in the population under study leaving the potential for future epidemics, and impedes national and international targets of disease reduction or elimination.

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

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

DTPa:

Diphtheria, tetanus, acellular pertussis component vaccine

IPV:

Inactivated poliomyelitis vaccine

OPV:

Oral poliomyelitis vaccine

Hib:

Haemophilus influenzae type B vaccine

hep B:

Hepatitis B vaccine

MMR:

Measles, mumps, rubella vaccine

Td:

Reduced diphtheria toxoid and tetanus toxoid vaccine

Tdpa:

Td, plus reduced antigen acellular pertussis component vaccine

References

  1. Arenz S, Schmitt HJ, Tischer A, von Kries R (2005) Effectiveness of measles vaccination after household exposure during a measles outbreak: a household contact study in Coburg, Bavaria. Pediatr Infect Dis J 24:697–699

    Article  PubMed  Google Scholar 

  2. 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

    Article  PubMed  CAS  Google Scholar 

  3. Centers for Disease Control and Prevention (2003) Public health and aging: influenza vaccination coverage among adults aged ≥50 years and pneumococcal vaccination coverage among adults aged ≥65 years-United States, 2002. MMWR Morb Mortal Wkly Rep 52:987–992

    Google Scholar 

  4. 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

    Google Scholar 

  5. Denis F (2004) Hepatitis B vaccination in France: vaccination coverage in 2002. Bull Acad Natl Med 188:115–123

    PubMed  Google Scholar 

  6. Dombkowski KJ, Lantz PM, Freed GL (2004) Risk factors for delay in age-appropriate vaccination. Public Health Rep 119:144–155

    PubMed  Google Scholar 

  7. Fogarty KJ, Massoudi MS, Gallo W, Averhoff FM, Yusuf H, Fishbein D (2004) Vaccine coverage levels after implementation of a middle school vaccination requirement, Florida, 1997–2000. Public Health Rep 119:163–169

    PubMed  Google Scholar 

  8. Giorgi Rossi P, Faustini A, Spadea T, Perucci CA (2004) Choosing immunisation coverage indicators at the local level. Eur J Epidemiol 19:979–985. Erratum in: Eur J Epidemiol 2004;19:1141

    Article  PubMed  Google Scholar 

  9. Gonzalez IM, Averhoff FM, Massoudi MS, Yusuf H, DeStefano F, Kramarz P, Maher JE, Mullooly JP, Chun C, Davis RL, Black SB, Shinefield HR, Vaccine Safety Datalink Team (2002) Hepatitis B vaccination among adolescents in 3 large health maintenance organizations. Pediatrics 110:929–934

    Article  PubMed  Google Scholar 

  10. 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

    Article  PubMed  CAS  Google Scholar 

  11. Humiston SG, Rosenthal SL (2005) Challenges to vaccinating adolescents: vaccine implementation issues. Pediatr Infect Dis J 24:S134–S140

    Article  PubMed  Google Scholar 

  12. Kalies H, von Kries R (2005) Durchimpfungsraten bei Kindern in Deutschland. Monatsschr Kinderheilkd 153:854–861

    Article  Google Scholar 

  13. Kalies H, Grote V, Schmitt HJ, von Kries R (2005) Immunisation status of children in Germany: temporal trends and regional differences. Eur J Pediatr 2005 Sep 14; [Epub ahead of print]

  14. 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

    Article  PubMed  CAS  Google Scholar 

  15. Oster NV, McPhillips-Tangum CA, Averhoff F, Howell K (2005) Barriers to adolescent immunization: a survey of family physicians and pediatricians. J Am Board Fam Pract 18:13–19

    Article  PubMed  Google Scholar 

  16. Reiter S (2004) Vaccination coverage in Germany. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 47:1144–1150

    Article  CAS  Google Scholar 

  17. Robert Koch-Institut (2005) Impfempfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut. Stand: Juli 2005. Epidem Bull 30:257–272

    Google Scholar 

  18. Schaffer SJ, Humiston SG, Shone LP, Averhoff FM, Szilagyi PG (2001) Adolescent immunization practices: a national survey of US physicians. Arch Pediatr Adolesc Med 155:566–571

    PubMed  CAS  Google Scholar 

  19. Schmidt RM, Middleman AB (2001) The importance of hepatitis B vaccination among adolescents. J Adolesc Health 29:217–222

    Article  PubMed  CAS  Google Scholar 

  20. 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 1993;91:545

    PubMed  CAS  Google Scholar 

  21. Szilagyi PG, Rodewald LE (1996) Missed opportunities for immunizations: a review of the evidence. J Public Health Manag Pract 2:18–25

    PubMed  CAS  Google Scholar 

  22. World Health Organization (2005) : http://www-nt.who.int/vaccines/globalsummary/Immunization/CountryProfileSelect.cfm. Accessed December 5, 2005

  23. 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

    Google Scholar 

Download references

Acknowledgements

We are grateful to the participating students and their parents, to the heads of secondary schools for their support, and to Dr. P. Lederer, Public Health Service of the city of Erlangen, Germany, for assistance in preparing this investigation.

Author information

Authors and Affiliations

  1. University Children’s Hospital (UKBB), P.O. Box CH-4005, Basel, Switzerland

    Ulrich Heininger

  2. University Hospital for Children and Adolescents, Erlangen, Germany

    Kerstin Loos, Imke Lorenz & Wolfgang Rascher

Authors
  1. Ulrich Heininger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kerstin Loos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Imke Lorenz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wolfgang Rascher
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ulrich Heininger.

Additional information

This work contains data from the medical thesis of Kerstin Loos at the Medical Faculty, University of Erlangen, Germany.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Heininger, U., Loos, K., Lorenz, I. et al. Compliance with recommended immunizations in adolescents. Eur J Pediatr 165, 671–676 (2006). https://doi.org/10.1007/s00431-006-0161-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-006-0161-9

Keywords

Search

Navigation