Poethko-Müller C, Mankertz A
Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013 Sep;56(9):1243-52. doi: 10.1007/s00103-013-1790-6.
Measles is a vaccine-preventable disease that could be eliminated by global vaccination strategies with two-dose measles vaccination. The World Health Organization (WHO) European Region aims at achieving measles elimination by 2015. Target control is mainly based on verification of 95 % vaccination coverage. In Germany, target verification cannot be based on data from centrally collected registers on vaccination and seroprevalence of measles-specific antibodies.
This paper provides an overview of measles vaccination coverage and the timeliness of measles vaccination in birth cohorts 1989-2008. In addition, factors associated with vaccination gaps are described.
Primary data on vaccination coverage (annual school entrance health examination) and on vaccination coverage and immune status (population-based German Health Interview and Examination Survey for Children and Adolescents - KiGGS) and secondary data (insurance refund claim data) are described and discussed.
The measles immunization coverage (two doses) obtained in the 2010 school entrance examinations was 91.5 %. The range was 87.6-95.3 % between Federal States. Regional differences were even more pronounced between districts. The timeliness of the two-dose measles immunization increased from 41 % (birth cohorts 2001/2002) to 66 % (birth cohorts 2006/2008). Despite progress in recent years, measles vaccination coverage is still inadequate in adolescents, young adults, and young children. The German Standing Committee on Vaccination (STIKO) recommends a combined MMR vaccination of adults who were born after 1970 and who were not fully vaccinated against measles during childhood. Successful implementation of this recommendation is crucial just as it is important to step up efforts to improve the timeliness of measles vaccination in young children. Regional vaccination gaps and susceptible clusters defined by age or sociodemographic parameters are of particular importance to the epidemiology of measles disease. Knowledge of the factors associated with nonimmunization should be used to tailor vaccination strategies.
麻疹是一种可通过两剂麻疹疫苗的全球疫苗接种策略消除的疫苗可预防疾病。世界卫生组织（WHO）欧洲区域的目标是到2015年消除麻疹。目标控制主要基于95%疫苗接种覆盖率的核实。在德国，目标核实不能基于集中收集的麻疹特异性抗体疫苗接种和血清流行率登记数据。
本文概述了1989 - 2008年出生队列中麻疹疫苗接种覆盖率及麻疹疫苗接种的及时性。此外，还描述了与疫苗接种缺口相关的因素。
描述并讨论了疫苗接种覆盖率的原始数据（年度入学健康检查）、疫苗接种覆盖率和免疫状态的原始数据（基于人群的德国儿童和青少年健康访谈与检查调查 - KiGGS）以及二手数据（保险退款申请数据）。
2010年入学检查中的麻疹免疫接种覆盖率（两剂）为91.5%。联邦州之间的范围为87.6 - 95.3%。地区之间的差异在各行政区更为明显。两剂麻疹免疫接种的及时性从41%（2001/2002年出生队列）提高到了66%（2006/2008年出生队列）。尽管近年来有所进展，但青少年、年轻成年人和幼儿的麻疹疫苗接种覆盖率仍然不足。德国疫苗接种常设委员会（STIKO）建议对1970年以后出生且儿童时期未完全接种麻疹疫苗的成年人进行MMR联合疫苗接种。成功实施这一建议至关重要，同样重要的是加大力度提高幼儿麻疹疫苗接种的及时性。由年龄或社会人口统计学参数定义的地区疫苗接种缺口和易感人群对麻疹疾病的流行病学尤为重要。应利用与未接种疫苗相关因素的知识来制定疫苗接种策略。
