title: Decline of varicella vaccination in German surveillance regions after recommendation of separate first-dose vaccination for varicella and measles-mumps-rubella.
abstract: BACKGROUND
  Germany introduced routine varicella (V) vaccination in 2004. Due to a slightly increased risk of febrile convulsions after first-dose application of combined measles-mumps-rubella-varicella (MMRV) vaccine separate first-dose vaccinations with MMR and monovalent V vaccine were recommended in September 2011.
  
  
  METHODS
  We compared V and MMR vaccinations in paediatric practices from two surveillance regions (Munich and Würzburg) one year before and after the change in the recommendation.
  
  
  RESULTS
  A total of 1405/326 monthly reports were provided by a monthly average of 79/14 practices participating in Munich/Würzburg. V first-dose vaccinations (monovalent V or MMRV vaccine) declined by 12% in Munich (from 10.1 to 8.9 vaccinations per month and practice; p<0.005) and by 4% in Würzburg (from 9.9 to 9.5; p=0.620), respectively. First-dose vaccinations for MMR (MMR or MMRV vaccine) did not change significantly in both regions.
  
  
  CONCLUSIONS
  Acceptance of V vaccination depends in part on the use of combination vaccine.
authors.affiliation: Department of Paediatrics, University of Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany. Electronic address: Streng_A@ukw.de.
authors.forename: Andrea
authors.initials: A
authors.lastname: Streng
authors.affiliation: Department of Paediatrics, University of Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany.
authors.forename: Johannes G
authors.initials: JG
authors.lastname: Liese
mesh_terms: D000293:Adolescent; D019433:Chickenpox Vaccine / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005858:Germany; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage*; D010372:Pediatrics / Q000379:methods; D062486:Public Health Surveillance; D014611:Vaccination / Q000706:statistics & numerical data*; D017778:Vaccines, Combined / Q000008:administration & dosage
chemical_list: D019433:Chickenpox Vaccine; D022542:Measles-Mumps-Rubella Vaccine; D017778:Vaccines, Combined; C050102:measles, mumps, rubella, varicella vaccine
keywords: Surveillance; Vaccination; Varicella