Risk Factors for Undervaccination against Measles in a Large Sample of Preschool Children from Rural Bavaria

Abstract.

Background:

Due to insufficient vaccination rates, measles outbreaks still pose a threat to public health in Germany. The purpose of this study was to identify risk factors for undervaccination against measles.

Patients and Methods:

Datasets from two cross-sectional surveys were analyzed by logistic regression models. The surveys had been done prior to and after an intervention aiming to raise measles, mumps, and rubella vaccination rates among children entering primary school in five Bavarian counties. Subjects were 9,582 children aged 6 to 7 years and their parents.

Results:

Main independent predictors of non-immunization were doctors advising against vaccination (OR 84.8; 95% CI 19.9–360.4), doctors abstaining from advice (OR 6.3; 95% CI 4.8–8.4), and parental reservations due to alternative health beliefs (OR 27.9; 95% CI 17.6–44.1).

Conclusion:

Doctors advising against measles vaccination and doctors not giving any advice proved to be important risk factors for childhood undervaccination against measles. Future strategies to increase measles vaccination rates in Germany should focus more on family doctors.