ArticleBMC public health2017
Heterogeneity in coverage for measles and varicella vaccination in toddlers - analysis of factors influencing parental acceptance.
Article in BMC public health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Resources for assessing parents' vaccine hesitancy: a systematic review of the literature.Journal of preventive medicine and hygiene · 2020Pooled it
- Universal varicella vaccination programmes in European countries and their effect: A systematic review.Public health in practice (Oxford, England) · 2026Article
- Impact of Revised Vaccination Recommendations for Mature Infants on Premature Infants' Vaccination Compliance in Germany.Infectious diseases and therapy · 2025Article
- AI based predictive acceptability model for effective vaccine delivery in healthcare systems.Scientific reports · 2024Article
- Article
- Factors Associated with Vaccination Uptake among Young Children: A Follow-Up Study of 1799 Toddlers.Vaccines · 2023Article
- Evolving measles status and immunization policy development in six European countries.Human vaccines & immunotherapeutics · 2022Review
- Social clustering of unvaccinated children in schools in the Netherlands.Epidemiology and infection · 2022Article
- Acceptance of varicella vaccination.Human vaccines & immunotherapeutics · 2021Article
- Probabilistic reconstruction of measles transmission clusters from routinely collected surveillance data.Journal of the Royal Society, Interface · 2020Article
- Specific Varicella-Related Complications and Their Decrease in Hospitalized Children after the Introduction of General Varicella Vaccination: Results from a Multicenter Pediatric Hospital Surveillance Study in Bavaria (Germany).Infectious diseases and therapy · 2019Article
- Can Flanders resist the measles outbreak? Assessing vaccination coverage in different age groups among Flemish residents.Epidemiology and infection · 2018Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 2004, routine varicella vaccination was introduced in Germany for children aged 11-14 months. Routine measles vaccination had already been introduced in 1973 for the same age group, but coverage is still too low (<95%) in some areas to eliminate measles. The present study assessed varicella and measles vaccination coverage and determinants of parental acceptance in two study regions, situated in Northern and Southern Bavaria (Germany).
methodsFrom 2009 to 2011, annual cross-sectional parent surveys were performed on random samples of 600 children aged 18-36 months in the Bavarian regions of both Munich and Würzburg. Logistic regression models were used to identify factors associated with varicella and measles vaccination.
resultsIn 2009, 2010 and 2011, vaccination coverage was lower in Munich than in Würzburg, for both varicella (Munich 53%, 67%, 69% vs. Würzburg 72%, 81%, 83%) and for measles (Munich 88%, 89%, 91% vs. Würzburg 92%, 93%, 95%). Recommendation by the physician was the main independent factor associated with varicella vaccination in both regions (adjusted odd ratios (OR) with 95% confidence interval (CI): Munich OR 19.7, CI 13.6-28.6; Würzburg OR 34.7, CI 22.6-53.2). Attendance at a childcare unit was positively associated with a higher acceptance of varicella vaccination in Munich (OR 1.5, CI 1.1-2.2). Regarding measles vaccination, attendance at a childcare unit was positively associated in both regions (Munich OR 2.0; CI 1.3-3.0; Würzburg OR 1.8; CI 1.1-3.1), and a higher level of parental school education was negatively associated in Würzburg (OR 0.5, CI 0.3-0.9).
conclusionsVaccination rates differed between regions, with rates constantly higher in Würzburg. Within each region, vaccination rates were lower for varicella than for measles. Measles vaccination status was mainly dependent upon socio-demographic factors (attendance at a childcare unit, parental school education), whereas for the more recently introduced varicella vaccination recommendation by the physician had the strongest impact. Hence, different strategies are needed to further improve vaccination rates for both diseases.
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