The status of vaccine preventable diseases in Germany

Abstract

The European members of the World Health Assembly (WHO) adopted the goal of eliminating poliomyelitis by the year 2000 (certification 2003), tetanus of the newborn by 2005 and measles by 2007 (certification 2010). Regarding the reduction by 2010 diphtheria, hepatitis B, pertussis and rubella syndrome are in the foreground of discussions. As WHO-member Germany looks after these aims with growing acceptance, too. The current situation of the specific target illnesses is differentiated in the eastern and western part of Germany. While the final stage of certification for a polio-free region in the whole of Germany has been reached and there have only been single illnesses of diphtheria and tetanus for years, there are reported more than 5,000 illnesses of hepatitis B every year with an estimated number of unknown cases of at least 15,000 clinically manifested illnesses and a high age specific incidence rate for people who are 20-40 years old. The incidence rate in the eastern federal states is lower than in the western federal states owing to a smaller portion of endangered risk groups in the population. The trend on the whole is declining. Useful epidemiological data of measles and pertussis are currently only available in the eastern federal states of reunited Germany. To control measles a national intervention programme "measles, mumps, rubella" was started. The aim of this programme is to reduce the illnesses of measles in Germany from currently 50 to at first 5 illnesses per 100,000 inhabitants. In the eastern German federal states the situation is still better than in the western federal states. However, a permanent lower incidence rate of less than 1/100,000 inhabitants has not been reached after 1990. Pertussis is an example for the consequences of different vaccination strategies in East and West. The estimated illness rates in the western federal states are at 80-100/100,000 inhabitants. In the eastern federal states a continuous increase of incidence rates of more than 5 per 100,000 inhabitants has been noticed since 1991. For a permanent reduction of incidence rates of infectious diseases which are preventable by vaccination, provable high vaccination coverage and an effective epidemiological control are necessary.