title: Tick borne encephalitis (TBE)-vaccination coverage and analysis of variables associated with vaccination, Sweden.
abstract: To estimate the tick borne encephalitis (TBE)-vaccination coverage in the greater Stockholm region, we sent a questionnaire to a randomized sample of 8000 individuals in 2013. Fifty-three percent of all respondents (n=4307) reported being vaccinated against TBE at least once. Reasons for not vaccinating included: no perceived risk (28.6%), too expensive (25.6%), did not have the time or opportunity (23%) and worried about vaccine side-effects (20.5%). Multiple logistic regression revealed that the probability of being vaccinated was higher among those who reported ≥2 weeks outdoor exposure in a known high risk area (OR 4.13 95% CI 3.54-4.81) and in individuals ≥60 years of age compared to all other age groups (OR 0.67 95% CI 0.55-0.81). A high net household income was associated with a higher probability of being vaccinated (OR 2.10 95% CI 1.6-2.73). Being born outside Europe was negatively correlated (OR 0.57 95% CI 0.39-0.83). Based on our findings the estimated TBE-incidence in the unvaccinated regional population was 8.5-12/100,000 which is comparable with high endemic areas as the Baltic region and Central Europe. We suggest targeted vaccination and reimbursement strategies in high-endemic areas of Sweden. Our results indicate a need for improved public information about TBE.
authors.affiliation: Department of Communicable Diseases Control and Prevention (Smittskydd Stockholm), Box 1753, SE 11891 Stockholm, Sweden; Department of Medicine/Unit for Infectious Diseases/Solna/Karolinska Institutet, 17176 Stockholm, Sweden. Electronic address: helena.hervius.askling@ki.se.
authors.forename: Helena Hervius
authors.initials: HH
authors.lastname: Askling
authors.affiliation: Department of Communicable Diseases Control and Prevention (Smittskydd Stockholm), Box 1753, SE 11891 Stockholm, Sweden; Department of Medicine/Unit for Infectious Diseases/Solna/Karolinska Institutet, 17176 Stockholm, Sweden. Electronic address: mona.insulander@sll.se.
authors.forename: Mona
authors.initials: M
authors.lastname: Insulander
authors.affiliation: Department of Communicable Diseases Control and Prevention (Smittskydd Stockholm), Box 1753, SE 11891 Stockholm, Sweden; Department of Medicine/Unit for Infectious Diseases/Solna/Karolinska Institutet, 17176 Stockholm, Sweden. Electronic address: maria-pia.hergens@sll.se.
authors.forename: Maria-Pia
authors.initials: MP
authors.lastname: Hergens
authors.affiliation: Department of Communicable Diseases Control and Prevention (Smittskydd Stockholm), Box 1753, SE 11891 Stockholm, Sweden; Department of Medicine/Unit for Infectious Diseases/Solna/Karolinska Institutet, 17176 Stockholm, Sweden. Electronic address: aleval@its.jnj.com.
authors.forename: Amy
authors.initials: A
authors.lastname: Leval
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004675:Encephalitis, Tick-Borne / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011897:Random Allocation; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data*; D014765:Viral Vaccines / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D014765:Viral Vaccines
keywords: Tick-borne encephalitis—TBE; Vaccination; Vaccine-preventable diseases; Zoonotic infections