[Vaccinations in early infancy -- results of an epidemiological cross-sectional study in Hamburg].
BACKGROUND
National recommendations for vaccine policies in Germany were changed in 2001. Following this advice childhood vaccination for nine preventable diseases including measles, mumps, and rubella (MMR) should be completed within the first two years of life. To achieve this it is recommended that plurivalent combination vaccines should be used. As data on current practice is generally rare and not available for the State of Hamburg, a cross-sectional study amongst families from Hamburg with children born during the year 2000 was conducted between April and August 2003.


METHODS
A random sample from the resident register was drawn. Structured telephone interviews were conducted. Information on vaccine status and time of vaccination was collected based on individual vaccination documents.


RESULTS
366 families were included in the study. 286 families (78 %) provided information. For 223 families the statements were reliably confirmed. In this group 180 children (80.7 % CI 76 - 86 %) had received at least one dose of MMR vaccine. 112 (50.2 % CI 44 - 57 %) had received two doses. Within the recommended time intervals 49 % had received the first, respectively 46 % had received the second MMR vaccination. A hexavalent contains vaccine containing the other six antigens was used for 138 of the 223 children (62 % CI 55 - 68 %). For 84 of those children (61 %) vaccination was completed with four doses. For 73 children other combinations including single valent vaccines were used. Among those for only 20 children (27.3 %) a completed vaccination status was reached during the recommended time interval. This gap was mainly due to missing hepatitis B vaccinations. The chance for their vaccination to be completed was more than twice as high for children who received the hexavalent combination vaccine compared to the others (RR 2.5; 95 % CI 1.6 - 3.9).


CONCLUSIONS
The results indicate that the recommendations to complete MMR vaccinations earlier are recognised. Nevertheless about half of the children were vaccinated later than recommended. In order to achieve vaccination coverage which will allow to achieve the goal of measles eradication substantial efforts are still required. Due to relatively large rates of incomplete vaccinations for the other antigens activities should focus on a timely completion of the gaps. The potential of combination vaccines to reach this aim is evident.
Fell
G
G
Zentrum für Impfmedizin und Infektionsepidemiologie des Instituts für Hygiene und Umwelt, Hamburg. gerhard.fell@ha.hamburg.de
David
C
C
Reintjes
R
R
D000367:Age Factors; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005858:Germany; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007407:Interviews as Topic; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage*; D014611:Vaccination / Q000639:trends*
D022542:Measles-Mumps-Rubella Vaccine