Takla Anja, Schmid-Küpke Nora, Wichmann Ole
Fachgebiet Impfprävention, STIKO, Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin, Deutschland.
Robert Koch-Institut, Seestr. 10, 13353, Berlin, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2025 Apr;68(4):416-425. doi: 10.1007/s00103-025-04029-1. Epub 2025 Mar 8.
Even more than 15 years after the first vaccination recommendation by the Standing Committee on Vaccination (STIKO) against human papillomaviruses (HPV), vaccination coverage in Germany remains low. As a possible measure to increase HPV vaccination coverage in Germany, the widespread introduction of HPV school vaccination programs, as they exist in other European countries, is often called for. However, any implementation of a widespread health intervention should be preceded by an evidence assessment that also takes national circumstances into account. This article provides an overview of the evidence available to date on the effect of school vaccination programs in Germany and discusses the results. Corresponding evidence is so far limited and comes from three local (pilot) programs. These show that about one-third of those not vaccinated took up the school vaccination offer, while two-thirds did not. No program in Germany has yet collected data on the reasons for not accepting the vaccination offer or whether any hesitancy that may exist relates to the place of vaccination (school) or the vaccination itself. Furthermore, there is a lack of cost-benefit analyses of school vaccination programs. This would be important for their evaluation due to the structures that would have to be newly established in Germany for this purpose. Based on the evidence available to date, it seems rather unlikely that the introduction of a comprehensive school vaccination program could significantly increase HPV vaccination rates in Germany. However, in addition to other measures, school vaccination programs could possibly be part of a structured vaccination system for specific target groups or in certain defined regions. In contrast to the existing vaccination system in Germany, such a structured vaccination system could ensure that all members of the target group are actively offered HPV vaccination.
即使在德国疫苗接种常务委员会（STIKO）首次建议接种人乳头瘤病毒（HPV）疫苗超过15年后，德国的疫苗接种覆盖率仍然很低。作为提高德国HPV疫苗接种覆盖率的一项可能措施，人们经常呼吁广泛推行其他欧洲国家现有的HPV学校疫苗接种计划。然而，在广泛实施任何健康干预措施之前，都应进行证据评估，且这种评估也要考虑到国情。本文概述了目前可获得的关于德国学校疫苗接种计划效果的证据，并对结果进行了讨论。到目前为止，相应的证据有限，且来自三个地方（试点）项目。这些项目表明，约三分之一未接种疫苗的人接受了学校提供的疫苗接种，而三分之二的人没有接受。德国还没有任何项目收集关于不接受疫苗接种提议的原因的数据，也没有收集是否存在的任何犹豫与接种地点（学校）或疫苗本身有关的数据。此外，缺乏对学校疫苗接种计划的成本效益分析。鉴于为此目的在德国必须重新建立的结构，这对于评估这些计划很重要。根据目前可获得的证据，引入全面的学校疫苗接种计划似乎不太可能显著提高德国的HPV疫苗接种率。然而，除其他措施外，学校疫苗接种计划可能是针对特定目标群体或某些特定地区的结构化疫苗接种系统的一部分。与德国现有的疫苗接种系统不同，这样一个结构化疫苗接种系统可以确保目标群体的所有成员都能被积极提供HPV疫苗接种。
