Varicella vaccination: a laboured take-off

AbstractVaricella vaccines are highly immunogenic, efficacious and safe in preventing varicella disease. The USA has been the first country recommending universal vaccination. In the European Union/European Economic Area countries, the use of varicella vaccine is heterogeneous, with some countries recommending universal vaccination in children at national or regional level, others only in high-risk groups and others having no recommendation at all. Uncertainties on the potential impact of varicella vaccination on the epidemiology of varicella and herpes zoster still exist. These uncertainties are the main reason behind the diverse vaccine recommendations. Surveillance systems and mathematical models could be useful to address these uncertainties. However, the lack of surveillance of varicella and herpes zoster in some countries, as well as the high variability of surveillance systems in the countries that have one, makes it difficult to assess the effect of the vaccine. On the other hand, mathematical models are based on assumptions and should be interpreted carefully. Continuous surveillance of varicella and herpes zoster is needed to identify any changes in the epidemiological presentation of the diseases. In any case, continuous surveillance will be needed to fully describe the impact of the programmes currently running and clarify some of the actual uncertainties in the near future. Additionally, increasing our understanding of the risk factors for development of herpes zoster is required

Healthcare workers' role in keeping MMR vaccination uptake high in Europe: a review of evidence

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Imported malaria in a cosmopolitan European city: A mirror image of the world epidemiological situation

© 2008 Millet et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Actual immunization coverage throughout Europe: are existing data sufficient?

Assessing vaccine coverage is an essential component of vaccine programme monitoring and evaluation. Vaccine coverage data are available in EU/EEA countries at both national and subnational levels and are used for programmatic purposes at any level. European-wide data collection is performed by WHO through the Centralized Information System for Infectious Diseases, as part of the global data collection jointly conducted with UNICEF. Data quality and comparability are still challenging at an international level. According to available information, vaccination registries are available in 11 countries in the EU/EEA, but only in five countries do they have national coverage. In 2012 ECDC, through the VENICE II network, started the European Vaccination Coverage Collection System (EVACO project), with the final aim of improving the quality of vaccine coverage data at EU level, by defining and implementing standards

Healthcare workers’ role in keeping MMR vaccination uptake high in Europe: a review of evidence

Measles is a highly contagious and potentially fatal disease. Europe is far from the 95% coverage rates necessary for elimination of the disease, although a safe and cost-effective vaccine is available. We reviewed the literature on studies carried out in European countries from January 1991 to September 2011 on knowledge, attitudes and practices of health professionals towards measles vaccination and on how health professionals have an impact on parental vaccination choices. Both quantitative and qualitative studies were considered: a total of 28 eligible articles were retrieved. Healthcare workers are considered by parents as a primary and trustworthy source of information on childhood vaccination. Gaps in knowledge and poor communication from healthcare workers are detrimental to high immunisation rates. Correct and transparent information for parents plays a key role in parental decisions on whether to have their children vaccinated. Healthcare workers' knowledge of and positive attitudes towards measles-mumps-rubella (MMR) vaccination are crucial to meeting the measles elimination goal. An effort should be made to overcome potential communication barriers and to strengthen vaccine education among healthcare professionals

Measles still spreads in Europe: who is responsible for the failure to vaccinate?

All countries in the European Region of the World Health Organization (WHO) have renewed their commitment to eliminate measles transmission by 2015. Measles elimination is a feasible target but requires vaccination coverage above 95% with two doses of a measles-mumps-rubella vaccine (MMR) in all population groups and in all geographical areas. Measles has re-emerged in the EU recently, due to suboptimal immunization levels that led to accumulation of susceptible populations over the last years. In fact, while an overall decreasing trend had been observed until 2009, the number of cases increased by a factor of four between 2010 and 2011. According to vaccination coverage data reported to the WHO, between 2000 and 2010, almost 5 million individuals in the EU in the age group 2-12 had not had MMR vaccination. Catch-up vaccination activities for susceptible populations are paramount in order to reach the elimination goal, but only feasible if a multi-component approach is put in place quickly and efficiently. Advocacy and communication are key strategic areas