Social differences in COVID-19 vaccination status – Results of the GEDA 2021 study

Background: The COVID-19 vaccination is a key measure to contain the pandemic. It aims to restrict new infections and to reduce severe courses of the disease. This paper examines the influence of various social determinants on COVID-19 vaccination status. Methods: The analyses are based on data from the study German Health Update (GEDA 2021), a nationwide telephone-based survey of the adult population in Germany, which was conducted between July and December 2021. In addition to bivariate analyses, the association between the COVID-19 vaccination status and the social determinants was examined using Poisson regression. Results: A total of 86.7% of people aged 18 years and older who participated in GEDA 2021 have been received at least one dose of COVID-19 vaccine. Social differences are evident: The proportion of people vaccinated against COVID-19 increases with age, income and higher education group. Lower vaccination rates are found among people with a history of migration, people living in rural areas and people from East Germany. An age-differentiated analysis shows that the social differences in COVID-19 vaccination uptake are lower among those aged 60 years and older. Conclusions: The presented results should be considered when designing targeted interventions to overcome potential barriers to COVID-19 vaccination uptake. Further research is needed regarding the explanatory factors for the social differences in vaccination behaviour, such as structural and group-specific barriers or psychological determinants

Pertussis-Impfquoten bei Erwachsenen in Deutschland

Hintergrund: Während in Deutschland seit 2001 eine Pertussis-Impfempfehlung für Risikogruppen besteht, wird erst seit 2009 von der Ständigen Impfkommission allen Erwachsenen die einmalige Pertussis-Impfung bei der nächsten fälligen Tetanus-Diphtherie-Auffrischimpfung empfohlen. Ziele dieser Studie waren: 1) Erhebung von Pertussis-Impfquoten bei Erwachsenen, 2) Abschätzung der Verwendungshäufigkeit tetanushaltiger Kombinationsimpfstoffe in Krankenhäusern. Methoden: Für 1) wurden Daten zweier bevölkerungsrepräsentativer Telefonsurveys unter Erwachsenen 2009/2010 analysiert (GEDA09: n = 21 262; GEDA10: n = 22 050). Einflussfaktoren des Pertussis-Impfstatus in Risikogruppen wurden mit logistischen Regressionsverfahren bestimmt. Für 2) wurde eine Befragung von 133 Krankenhausapotheken (betreuen 454 Krankenhäuser) für das Jahr 2007 durchgeführt. Ergebnisse: In GEDA10 hatten 5,9 % (95 %-Konfidenzintervall [KI] 5,5–6,3 %) der Befragten einen ausreichenden Pertussis-Impfschutz (Impfung in letzten 10 Jahren). Erwachsene, die einer Risikogruppe angehörten, hatten eine Impfquote von 10,7 % (95 %-KI 9,8–11,7 %). Mit höheren Pertussis-Impfquoten in Risikogruppen signifikant assoziiert waren u. a. Wohnort in den neuen Bundesländern und jüngeres Alter. Entgegen geltender Empfehlung wurden ca. 75 % der Tetanus-Impfungen in Notaufnahmen bzw. Stationen als monovalente Impfung verabreicht. Schlussfolgerungen: Angesichts hoher Pertussis-Inzidenzen und niedriger Durchimpfung in Risikogruppen und der Allgemeinbevölkerung ist die Steigerung der Pertussis-Impfquoten in Deutschland dringend geboten. Impfquotensteigernde Maßnahmen sollten unbedingt die impfende Ärzteschaft miteinbeziehen.Background: Pertussis vaccination for risk-groups (e. g. healthcare workers, employees of communal facilities, or persons with close contact to infants) has been recommended in Germany since 2001.  In 2009, single-dose acellular pertussis (ap) vaccination was recommended for all adults at the next tetanus-diphtheria (Td) booster. Study aims were to assess 1) pertussis vaccination coverage in adults, and 2) use of tetanus-containing combination vaccines in hospitals. Methods: For 1) we analysed data from two population-based telephone surveys conducted among adults in Germany in 2009/2010 (GEDA09: n = 21 262; GEDA10: n = 22 050). Factors associated with vaccination were identified by logistic regression analyses. For 2) a questionnaire survey of 133 hospital pharmacies serving 454 German hospitals was undertaken for the year 2007. Results: Overall, 5.9 % (95 % confidence interval [CI] 5.5–6.3 %) of GEDA10 participants reported up-to-date pertussis vaccination (ap-vaccination in past 10 years). In risk-groups, vaccination coverage was 10.7 % (95 %-CI 9.8–11.7 %). Residence in former East-Germany and younger age were independently associated with an adequate vaccination status. Contrary to prevailing recommendations, ~75 % of tetanus vaccines were administered as monovalent rather than Td- (or Tdap-)combination vaccines in hospitals. Conclusions: In light of high pertussis-incidence and low vaccination coverage in German adults, improvement of pertussis vaccine uptake is vital, e. g. through awareness campaigns targeting both physicians in private practice and hospitals

Soziale Unterschiede im COVID-19-Impfstatus – Ergebnisse der Studie GEDA 2021

Hintergrund: Die Impfung gegen COVID-19 stellt eine wesentliche Maßnahme zur Eindämmung der Pandemie dar. Sie zielt darauf ab, Neuinfektionen einzuschränken und schwere Krankheitsverläufe zu reduzieren. Der vorliegende Beitrag untersucht den Einfluss verschiedener sozialer Determinanten auf den COVID-19-Impfstatus. Methode: Die Auswertungen basieren auf der Studie Gesundheit in Deutschland aktuell (GEDA 2021), die als bundesweite telefonische Befragung der erwachsenen Bevölkerung in Deutschland zwischen Juli und Dezember 2021 durchgeführt wurde. Neben bivariaten Analysen wurde der Zusammenhang zwischen der Inanspruchnahme der COVID-19-Impfung und den sozialen Determinanten mittels Poisson-Regression untersucht. Ergebnisse: Insgesamt 86,7 % der Personen ab 18 Jahren, die in GEDA 2021 teilgenommen haben, sind mindestens einmal gegen COVID-19 geimpft. Dabei zeigen sich soziale Unterschiede: Der Anteil geimpfter Personen nimmt mit dem Alter, Einkommen und hoher Bildungsgruppe zu. Niedrigere Impfquoten weisen Personen mit Migrationsgeschichte, im ländlichen Raum Lebende sowie Personen aus Ostdeutschland auf. Eine altersdifferenzierte Betrachtung verweist auf geringere soziale Unterschiede im COVID-19-Impfstatus in der Altersgruppe ab 60 Jahren. Schlussfolgerungen: Bei der Konzeption gezielter Maßnahmen zur Überwindung möglicher Impfbarrieren sollten die aufgezeigten Ergebnisse berücksichtigt werden. Es bedarf jedoch weiterführender Analysen zu den Erklärungsfaktoren für die sozialen Unterschiede im Impfverhalten, wie bspw. strukturelle Barrieren oder psychologische Determinanten

Health situation in Germany during the COVID-19 pandemic. Developments over time for selected indicators of GEDA 2019/2020 – An update

The spread of the coronavirus SARS-CoV-2 in 2020 and the containment measures associated therewith have changed many aspects of daily life. An impact on health even beyond infections itself is assumed as well. The health situation of the population in the first phase of the pandemic was thus analysed using data from the German Health Update (GEDA 2019/2020-EHIS). By continuing the survey, the analyses for 2020 are completed (n=26,507 participants), whereby the focus is now on the third phase of the pandemic (second wave of infection, gradual reintroduction of containment measures). The health indicators are presented on a monthly basis. As in the first phase of the pandemic, no pandemic-related changes were observed for tobacco smoking/ second-hand smoke exposure and for received/lack of/provided support. In contrast to the first phase of the pandemic, declines in utilisation of medical services and depressive symptoms are not observed in the third phase. The increase in body weight/body mass index after the first phase of the pandemic did not continue. The survey period allows for a comparison of the periods before and as of the pandemic situation. A decrease in the medical services utilisation and depressive symptoms as well as an increase in the body weight/body mass index is observed in the period from March 2020 to January 2021 compared to the pre-pandemic period from April 2019 to March 2020

Sozioökonomischer Status und Gesundheit

Menschen mit einem niedrigen sozioökonomischen Status haben schlechtere Gesundheitschancen und höhere Risiken für eine Vielzahl körperlicher und psychischer Erkrankungen als jene mit höherem sozioökonomischem Status. Dieser Beitrag gibt einen Überblick darüber, welche Daten und Befunde hierzu für Deutschland vorliegen und welche Entwicklungen sich in diesen beiden Bereichen abzeichnen. Dazu wird auf Basis verschiedener Datengrundlagen beschrieben, wie sich der Zusammenhang zwischen sozioökonomischem Status und Gesundheit vom Kindes- und Jugendalter bis ins höhere Lebensalter erstreckt und letztlich in einer sozial ungleichen Sterblichkeit und Lebenserwartung ausprägt.Peer Reviewe

Population-wide use of behavioural prevention and counselling programmes for lifestyle-related cardiovascular risk factors in Germany

Background: Behavioural prevention and counselling programmes for lifestyle-related cardiovascular risk factors are widely offered. However, their population-wide use is largely unexplored, particularly in high-risk persons with known CVD or diabetes. Methods: Data were collected within GEDA 2009, a national health survey covering a representative sample of 21,262 adults in Germany. Standardised structured computer-assisted telephone interviews included self-reported physician-diagnosed coronary heart disease, myocardial infarction, heart failure, stroke, diabetes as well as height, weight, usual diet, physical activity, and the use of programmes for weight reduction, healthy diet and improvement of fitness or mobility in the last twelve months. Results: The use of prevention measures was lowest for weight reduction (men 2.1%, women 3.5%), somewhat higher for healthy diet (men 3.2%, women 4.7%), and highest for improvement of fitness or mobility (men 8.6%, women 16.1%). Among individuals with the respective risk factor, programme participation was still low: 5.5% in obese men (women 7.2%) for weight reduction, 2.8% in men (women 3.7%) who did not eat fruit or vegetables daily for healthy diet, and 7.9% in physically inactive men (women 15.7%) for improvement of fitness or mobility. In the presence of known CVD or diabetes, participation increased inconsistently and only moderately. Conclusion: Our results show low participation in behavioural prevention measures for lifestyle-related risk factors even in individuals with known CVD or diabetes. Further studies should investigate knowledge about potential programme benefit, availability and reimbursement in both patients and health care providers

Measurement of socioeconomic status in the German Health Interview and Examination Survey for Adults (DEGS1)

Socioeconomic status (SES) constitutes a central analysis category of epidemiological research and health reporting. As part of the German Cardiovascular Disease Prevention Study 1984–1991, a multi-dimensional aggregated index was developed for the purpose of measuring SES. This index continues to be used in numerous studies to this day. For the purpose of health monitoring at the Robert Koch Institute (RKI), the index was fundamentally revised following critical assessment. This article describes the basic concepts underlying the revision and how they were implemented in relation to the German Health Interview and Examination Survey for Adults (DEGS1). In addition, the results of the age and sex-specific distribution of the values of the revised SES index and those relating to the connection with other measurements of socioeconomic status are reported. The results are based on the data of DEGS1 2012 and the German national health interview and examination survey 1998 (GNHIES98)

Seasonal influenza vaccine uptake in Germany 2007/2008 and 2008/2009: Results from a national health update survey

In 2008/2009 a nationwide cross-sectional telephone survey was conducted to assess, among other health-relevant parameters, seasonal influenza vaccination coverage. Data from 21,262 household-interviews representative of the adult population in Germany were collected and analyzed. In seasons 2007/2008 and 2008/2009, vaccine uptake in individuals aged ≥60 years was 57% and 55% and in individuals with underlying chronic diseases 44% and 42%. Living in the eastern part of Germany, higher age, and medium household income level were independently associated with higher vaccine uptake in both target groups. Healthcare workers were significantly less frequently (21.9% in 2007/2008; 20.4% in 2008/2009) vaccinated than the general population (30.8% and 28.1%). Special effort must be undertaken to develop immunization strategies for improved vaccine uptake in target groups, especially in healthcare workers