RÉSUMÉ
One of the special challenges in immunization policy is communication and access to adolescents. To identify barriers and enablers for the immunization of this specific target group, we conducted 11 focus group discussions with adolescents with and without migration background, mothers with Turkish and Russian migration background, and physicians in private practice in March 2011. The results showed that for adolescents, the utilization of immunization was guided by informational and organizational processes in families and by the consulting physician. The low awareness of immunization-related issues that was observed among adolescents is especially challenging, because routine visits to the doctor often stop with the transition from pediatric to adult health care. Immigration-related factors may additionally affect the utilization of immunization services. Besides improving access to information and lowering the barriers to immunization for adolescents in general, culturally sensitive interventions may be a promising approach for improving communication between mothers and the immunizing physician and thereby improving vaccination coverage in the adolescent target group.
Sujet(s)
Émigration et immigration/statistiques et données numériques , Compétence informationnelle en santé/statistiques et données numériques , Accessibilité des services de santé/statistiques et données numériques , Mères/statistiques et données numériques , Médecins/statistiques et données numériques , Population de passage et migrants/statistiques et données numériques , Vaccination/statistiques et données numériques , Adolescent , Femelle , Allemagne/épidémiologie , Humains , Mâle , Russie/ethnologie , Turquie/ethnologie , Jeune adulteRÉSUMÉ
The decreasing incidence of vaccine-preventable infectious diseases and their complications redirects public attention to the safety risks of vaccinations. Collation of resilient vaccine adverse reaction data from passive and active surveillance systems as well as epidemiological studies is indispensable. From 2003-2006, the representative National Health Interview and Examination Survey for Children and Adolescents ("Kinder- und Jugendgesundheitssurvey," KiGGS) retrospectively collected information about vaccines, vaccination dates, and suspected vaccine-related adverse events. A total of 15,958 participants (<17 years of age) were included in the analyses. Parents of 332 (2.1%; 95% CI 1.8-2.5) children and adolescents reported that one or more vaccinations were poorly tolerated. The reported adverse reactions were largely in accordance with information given in the summaries of product characteristics of the respective vaccines. Calculated rates of adverse reactions were below the known rates. KiGGS allowed the retrospective collection of suspected adverse reactions from a large number of vaccinations, thereby providing data even on rare adverse events. No unusual pattern was observed. The information obtained on suspected adverse reactions does not change the positive benefit-risk ratio of vaccinations.
Sujet(s)
Effets secondaires indésirables des médicaments/épidémiologie , Vaccination/statistiques et données numériques , Adolescent , Enfant , Enfant d'âge préscolaire , Femelle , Allemagne/épidémiologie , Humains , Nourrisson , Nouveau-né , Mâle , Prévalence , Appréciation des risques , Facteurs de risque , Résultat thérapeutiqueRÉSUMÉ
Each method to monitor vaccine safety has strengths and limitations. Therefore, vaccine safety monitoring should rely on different types of data sources. Methods commonly rely on patient-reported adverse reactions. Little is, however, known about factors that may affect the probability with which patients report adverse reactions to vaccines. From 2003-2006, the representative National Health Interview and Examination Survey for Children and Adolescents ("Kinder- und Jugendgesundheitssurvey", KiGGS) retrospectively collected information about vaccines, vaccination dates, and suspected vaccine related adverse reactions from a total of 17,641 participants (<17 years). Poorly tolerated vaccinations were more likely reported from parents living in former West Germany compared to former East Germany (OR 1.61; 95% CI 1.08-2.39), parents of children with special health care needs (OR 1.49; 95% CI 1.08-2.04), and from parents reporting reservations against vaccinations (OR 3.29; 95% CI 2.28-4.75). Parental reporting of adverse vaccine reactions appears to be associated with parental perception and assessment of possible adverse vaccine reactions, as well as with the parents' attitude towards immunization in general.
Sujet(s)
Effets secondaires indésirables des médicaments/épidémiologie , Parents , Vaccination/statistiques et données numériques , Adolescent , Enfant , Enfant d'âge préscolaire , Femelle , Allemagne/épidémiologie , Humains , Nourrisson , Nouveau-né , Mâle , Prévalence , Appréciation des risques , Facteurs de risque , Résultat thérapeutiqueRÉSUMÉ
In the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), which was conducted from 2003 to 2006, data on acute/infectious and chronic diseases were collected from a population-based sample of 17,641 subjects aged 0 to 17 years. The annual prevalence rates among acute diseases vary widely. Children and adolescents are most frequently affected by acute (infectious) respiratory conditions. 88.5 % of the surveyed children and adolescents experienced at least one episode of common cold within the last 12 months. Among the other acute respiratory infections, bronchitis and tonsillitis were the most frequently encountered conditions with 19.9 % and 18.5 %, respectively. The 12-month prevalence of otitis media and pseudocroup was 11 % and 6.6 %, respectively. 1.5 % of the children and adolescents experienced an episode of pneumonia. Apart from respiratory infections, gastrointestinal infections were very frequently stated as reasons for acute illness. Furthermore, 12.8 % of the children and adolescents experienced a herpetic infection, 7.8 % a conjunctivitis and 4.8 % a urinary tract infection. Lifetime prevalence rates of infectious diseases were as follows: pertussis 8.7 %, measles 7.4 %, mumps 4.0 %, rubella 8.5 %, varicella 70.6 %, scarlet fever 23.5 %. The various chronic somatic diseases in children and adolescents had different lifetime prevalence rates. Most frequently, children and adolescents were affected by obstructive bronchitis (13.3 %), neurodermatitis/atopic eczema (13.2 %) and hay fever (10.7 %). Scoliosis and asthma had been diagnosed by a doctor in 5.2 % and 4.7 % of subjects aged 0-17 years, respectively. The lifetime prevalence rates of the remaining diseases varied between 0.14 % for diabetes mellitus and 3.6 % for convulsions/epileptic fits. For the first time ever, these survey results provide nationwide representative information on the prevalence rates of acute/infectious and chronic diseases in children and adolescents which is based on a population-representative sample.
Sujet(s)
Maladie aigüe/épidémiologie , Maladie chronique/épidémiologie , Maladies transmissibles/épidémiologie , Adolescent , Enfant , Enfant d'âge préscolaire , Études transversales , Émigration et immigration/statistiques et données numériques , Femelle , Allemagne/épidémiologie , Enquêtes de santé , Humains , Nourrisson , Mâle , Environnement social , Facteurs socioéconomiquesRÉSUMÉ
In the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) from 2003-2006 information was collected on allergic diseases (asthma, atopic dermatitis, hay fever, allergic contact eczema) from a population-based sample of 17,641 0-to 17-year-olds, and blood samples were studied for specific IgE antibodies to 20 common allergens. The lifetime prevalence (LTP) of at least one atopic disease was 22.9 % (95 % CI: 22.0-23.7 %), the 12-month prevalence (12MP) was 16.1 % (15.4-16.8 %); boys (17.3; 16.3-18.2 %) were more frequently affected than girls (14.9; 14.0-15.8 %). Children with a background of migration were less often currently affected by an atopic disease, as were children from families of low social status. According to parents' accounts, the LTP of allergic contact eczema was 9.9 % (9.4-10.5 %); girls (13.8;12.9-14.8) were more frequently affected than boys (6.2; 5.6-6.9 %). Of the 3- to 17-year-olds, 40.8 % (39.6-42.0 %) were sensitised to at least one of the allergens tested; boys (45.0; 43.5-46.5 %) more frequently so than girls (36.4; 35.0-37.9 %). In the states of the former FRG, the LTP of allergic contact eczema was higher (10.2; 9.6-10.9 %) than those in the former GDR (8.4 % 7.4-9.6 %); otherwise there were no East-West differences. The KiGGS data provide the first nationally representative data on allergic diseases and sensitisation. The differences in prevalence observed correspond to a great extent with previous studies and may support the hygiene hypothesis. The prevalences in East and West Germany now seem to have equalised.