title: Compliance with recommended immunizations in adolescents.
abstract: BACKGROUND
  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.
authors.affiliation: University Children's Hospital (UKBB), P.O. Box CH-4005, Basel, Switzerland. Ulrich.Heininger@unibas.ch
authors.forename: Ulrich
authors.initials: U
authors.lastname: Heininger
authors.forename: Kerstin
authors.initials: K
authors.lastname: Loos
authors.forename: Imke
authors.initials: I
authors.lastname: Lorenz
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rascher
mesh_terms: D000293:Adolescent; D002648:Child; D003140:Communicable Disease Control; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D017589:Immunization Programs; D007115:Immunization Schedule; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage; D010349:Patient Compliance; D013334:Students / Q000706:statistics & numerical data; D014765:Viral Vaccines / Q000008:administration & dosage; D014777:Virus Diseases / Q000453:epidemiology / Q000517:prevention & control; D014917:Whooping Cough / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D022542:Measles-Mumps-Rubella Vaccine; D014765:Viral Vaccines