[National immunization program initiatives-What are their contribution to the elimination of measles and rubella in Germany?] / Nationale Initiativen im Impfwesen ­ Was können sie zur Elimination der Masern und Röteln in Deutschland beitragen?

In Germany, vaccinations, like the entire health sector, are organized at the federal level. A common strategy is necessary for the implementation of national immunization goals, e. g., for the elimination of measles and rubella, as intended by the World Health Organization (WHO). Current and reliable data concerning the vaccination status of the population on one hand and regional differences on the other hand are prerequisites for the identification of specified fields of action.In this paper, the strengths and challenges of the national immunization program in Germany are described, establishing the current status of the elimination of measles and rubella as a reference. Important criteria for the fulfilment of this goal, e. g., the achievement and maintenance of a vaccination coverage of 95% with two doses of vaccines against these two diseases, were again not met in 2018. Therefore, national initiatives will contribute to closing the immunity gaps, such as: the National Immunization Conference as a platform for the continuous communication between the main players and for the development of new ideas and suggestions, the national immunization plan and the 2015-2020 national action plan for the elimination of measles and rubella, which contains the goals and the required activities, and the national immunization steering group for prioritization of the agenda items and recommendations for the measures required for their realization as well as coordination of the national activities.The first results described in this paper suggest that the taken course is promising, but further efforts by all players are urgently needed.

Epidemiology of subacute sclerosing panencephalitis (SSPE) in Germany from 2003 to 2009: a risk estimation.

Subacute sclerosing panencephalitis (SSPE) is a fatal long-term complication of measles infection. We performed an estimation of the total number of SSPE cases in Germany for the period 2003 to 2009 and calculated the risk of SSPE after an acute measles infection. SSPE cases were collected from the Surveillance Unit for Rare Paediatric Diseases in Germany and the Institute of Virology and Immunobiology at the University of Würzburg. The total number of SSPE cases was estimated by capture-recapture analysis. For the period 2003 to 2009, 31 children with SSPE who were treated at German hospitals were identified. The capture-recapture estimate was 39 cases (95% confidence interval: 29.2-48.0). The risk of developing SSPE for children contracting measles infection below 5 years of age was calculated as 1∶1700 to 1∶3300. This risk is in the same order of magnitude as the risk of a fatal acute measles infection.