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Home Eurosurveillance Weekly Release  2004: Volume 8/ Issue 31 Article 1
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Eurosurveillance, Volume 8, Issue 31, 29 July 2004
Articles

Citation style for this article: Rasch G, Hellenbrand W. Germany adds varicella vaccine to the national vaccination programme. Euro Surveill. 2004;8(31):pii=2511. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2511

Germany adds varicella vaccine to the national vaccination programme

Gernot Rasch (raschg@rki.de) and Wiebke Hellenbrand, Robert Koch-Institut, Berlin, Germany

In July 2004 varicella (chickenpox) vaccination was added to the national routine vaccination schedule for all children in Germany, which is the first country in the European Union to do this [1]. The Ständige Impfkommission (standing committee on vaccination, STIKO) at the Robert Koch-Institut in Germany announced the change in their recently published update to the national vaccine schedule [2].

Previously, varicella vaccination was only recommended in Germany for particular risk groups (and their contacts), and for young people who had not had varicella. These recommendations were often not followed in the past.

In the United States, varicella vaccination has been standard for all children and young people since 1995, with good results [3,4]. The STIKO recommendations should reduce the high numbers of varicella infections in Germany - estimated at 750 000 cases per year. A reduction is also expected in the annual number of varicella-associated complications such as bacterial infections and their consequences (abscesses, skin infection) as well as rarer complications affecting the central nervous system such as brain inflammation, cerebellitis and encephalitis. This will reduce the need for hospital admission of infants and young children, the demands of sick children on parents and therefore the economic costs. For most vaccinations recommended by the STIKO, statutory health insurances cover the cost; however, no decisions have been made to date whether this will also hold for varicella vaccinations.

Herd immunity induced by mass vaccination will also protect non-immune infants, young children, pregnant women and people in risk groups. According to the official recommendations published in the Epidemiologisches Bulletin [2], varicella vaccination is scheduled for infants aged between 11 and 14 months (given preferably at the same time as MMR vaccine). Catch-up vaccination for children and adults is recommended, in particular for persons aged 9-17 years who have not had varicella infection.

National committees in Lithuania and Cyprus have also recommended varicella vaccination for all children, but as yet, this does not form part of their national routine vaccination schedule (A Nardone, ESEN-2, personal communication, July 2004).

References:
  1. Robert Koch-Institut. Neue Empfehlungen der Ständigen Impfkommission veröffentlicht. Press release. 26 July 2004. (http://www.rki.de/AKTUELL/PRARCHIV/ARCHIVPR.HTM?/PRESSE/PD/PD2004/PD04_20.HTM&1)
  2. Robert Koch-Institut. Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut / Stand: Juli 2004. Epidemiologisches Bulletin 2004; (30): 235-50. (http://www.rki.de/INFEKT/EPIBULL/2004/30_04.PDF)
  3. Seward JF, Watson BM, Peterson CL, et al. Varicella disease after introduction of varicella vaccine in the United States, 1995-2000. JAMA 2002; 287:606-11. (http://jama.ama-assn.org/issues/v287n5/abs/joc10385.html)
  4. Noah N. Varicella disease after introduction of varicella vaccine in the US, 1995-2000. Eurosurveillance Weekly 2002: 6(7): 14 February 2002 (http://www.eurosurveillance.org/ew/2002/020214.asp#2)

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