title: Immunization rates at the school entry in 2012.
abstract: BACKGROUND
  The immunization rates for some diseases, including measles, were so low in Germany in recent years that endemic outbreaks occurred. A finely detailed geographic analysis of immunization rates is necessary for the identification of under-immunized areas.
  
  
  METHODS
  We addressed this question with the aid of regional and local data from school entrance examinations, which were made available to us by the health departments of the German federal states. These data are represented both in tabular form and with the aid of a geographical information system (GIS).
  
  
  RESULTS
  The immunization rates for tetanus, pertussis, and poliomyelitis were high throughout Germany (96.5%, 95.6%, and 95.2%, respectively). In contrast, major variation across regions was seen in immunization rates for hepatitis B (range: 53.5% to 99.1%) and measles (52.1% to 98.3%), with higher immunization rates in areas of the former East Germany. Low immunization rates were particularly evident in some areas in the states of Bavaria and Baden-Württemberg. In some parts of Saxony (a state in the former East Germany), the official immunization recommendations differ from those of the nationwide Standing Committee on Vaccination (STIKO); as a result, these areas had a mean measles immunization rate of only 66.7% among children entering school.
  
  
  CONCLUSIONS
  High immunization rates were found across Germany for tetanus, pertussis, and poliomyelitis, although the rates in some regions were lower than they should be. Stronger informational efforts must be undertaken to improve the public acceptance of immunization against hepatitis B and measles, so that these immunization rates can rise. For measles in particular, uniform nationwide recommendations might help increase the immunization rate.
authors.affiliation: University Medicine Greifswald, Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Center for Child and Adolescent Medicine.
authors.forename: Martin
authors.initials: M
authors.lastname: Weigel
authors.forename: Roswitha
authors.initials: R
authors.lastname: Bruns
authors.forename: Kerstin
authors.initials: K
authors.lastname: Weitmann
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hoffmann
mesh_terms: D001424:Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D062211:Spatio-Temporal Analysis; D013334:Students / Q000706:statistics & numerical data*; D014777:Virus Diseases / Q000453:epidemiology / Q000517:prevention & control*