Routine immunization profile: Croatia

Routine immunization profile Croatia Progress towards achieving European Vaccine Action Plan goals, 2017 Goal Indicator Status Goal Indicator Status 1 Sustain polio-free status a (Current risk) Yes (Intermediate) 4 Meets vaccination coverage targets DTP3 national immunization coverage ≥95%d ≥90% DTP3 coverage achieved in ≥90% of districtse No No No 2 Measles elimination statusb Eliminated 5 Make evidence-based decisions about introduction of new vaccines*e NITAG made a recommendation about PCV NITAG made a recommendation about RV NITAG made a recommendation about HPV Yes Yes No YesRubella elimination status b Eliminated 3 Control hepatitis B infectionc Validation pending 6 Achieve financial sustainability of the national immunization programme**c Yes *New vaccines introduced or not introduced based on NITAG evidence-based recommendations **Country self-sufficient for procuring routine vaccines Demographic, income and health expenditure summary, 2017 Total Populationf 4 189 353 Live births 38 014 Surviving infants 37 889 <5 years 191 606 <15 years 615 359 Neonatal mortality rate (per 1000 live births)f 2.9 Infant mortality rate (per 1000 live births)f 3.9 Number of districtse 112 GNI (per capita, in USD)g 12 570 Health spending as % of total government expenditureg 12 Immunization schedule, 2017e Birth BCG 2M DTaPHibHepBIPV 4M DTaPHibHepBIPV 6M DTaPHibHepBIPV 1Y DTaPHibHepBIPV, MMR 5Y Tdap 6Y IPV, MMR 13Y HepB_Pediatric(3x) 14Y HPV(2x), IPV, Td 15Y HPV Routine immunization profile Croatia Vaccine coverage estimates, 2013-2017d Number of reported cases of vaccine- preventable diseases, 2013-2017e,i 2013 2014 2015 2016 2017 Measles 0 16 206 4 7 Mumps 35 34 29 33 15 Rubella 1 0 1 2 0 Congenital rubella syndrome 0 0 0 0 0 Diphtheria 0 0 0 0 0 Tetanus 1 1 3 0 2 Pertussis 108 130 57 122 80 Hepatitis A 16 7 4 5 47 Varicella 24 407 22 818 22 858 22 306 18 058 DTP3 reported coverage by subnational area†, 2017e MCV2 reported coverage by subnational area†, 2017eMCV1 reported coverage by subnational area†, 2017e Surveillance with laboratory confirmation of cases, 2017e Measles Yes Rubella Yes Congenital rubella syndrome Yes Rotavirus Yes Invasive meningococcal disease Yes Invasive pneumococcal disease Yes Invasive Haemophilus influenzae disease Yes Note: Case-based surveillance (with laboratory confirmation of cases) assessed for measles, rubella, and congenital rubella syndrome. Hospital-based sentinel surveillance and/or population-based surveillance (both with laboratory confirmation of cases) assessed for rotavirus, invasive meningococcal disease, invasive pneumococcal disease, and invasive Haemophilus influenzae disease. ≥95% 90-94% 80-89% <80% ND ≥95% 90-94% 80-89% <80% ND ≥95% 90-94% 80-89% <80% ND ND NR50 0100 2013 2014 2015 2016 2017 BCG 99 98 98 99 98 HepB-BD 98 98 NR NR NR DTP1 98 98 98 98 98 DTP3 96 95 94 93 92 HepB3 96 95 94 93 94 Hib3 96 95 94 93 87 Pol3 96 95 94 93 92 PCV3 NR NR NR NR NR Rotac NR NR NR NR NR RCV1 94 94 93 90 89 MCV1 94 94 93 90 89 MCV2 97 97 96 96 95 Routine immunization profile Croatia Number of reported measles, mumps and rubella casese and MCV coverage estimatesd, 2013-2017 DTP1-DTP3 dropout rate, 2013-2017d Note: Dropout rate is calculated using WUENIC Reported target population, reported number of DTP3 doses administered and DTP3 reported coveragee, 2013-2017 Number of reported diphtheria, tetanus and pertussis casese and DTP3 coverage estimatesd, 2013-2017 Percentage of districts by DTP3 reported coveragee, 2013-2017 Immunization system characteristics, 2017 Sustained access to WHO accredited polio, measles, and rubella laboratoriesh Yes NITAG in place that meets six WHO criteriae No National system in place to monitor AEFIse Yes Communication plan in place to respond to vaccine safety-related eventse No Vaccine hesitancy assessment performed within last 5 years e Yes Mandatory proof of immunization at school entrye Yes Note: The six WHO NITAG criteria are 1. legislative or administrative basis for the advisory group; 2. formal written terms of reference; 3. at least five different areas of expertise represented among core members; 4. at least one meeting per year; 5. circulation of the agenda and background documents at least one week prior to meetings; 6. mandatory disclosure of any conflict of interest 2 3 4 5 6 0 1 2 3 4 5 6 7 2013 2014 2015 2016 2017 DTP1-DTP3 dropout rate (%) Ye ar 0 20 40 60 80 100 0 5000 10000 15000 20000 25000 30000 35000 40000 45000 2013 2014 2015 2016 2017 % c ov er ag e N um be r Year DTP3 reported population DTP3 reported doses DTP3 reported coverage 95 95 90 90 78 4 5 10 10 12 2 4 7 0 20 40 60 80 100 2013 2014 2015 2016 2017 Percentage of subnational areas Ye ar ≥90% 80-89% 50-79% <50% ND 0 20 40 60 80 100 0 50 100 150 200 250 2013 2014 2015 2016 2017 % c ov er ag e N um be r o f c as es Year Measles Mumps Rubella MCV1 coverage MCV2 coverage 0 20 40 60 80 100 0 20 40 60 80 100 120 140 2013 2014 2015 2016 2017 % c ov er ag e N um be r o f c as es Year Diptheria Tetanus Pertussis DTP3 coverage Routine immunization profile Croatia Vaccine stockouts by administrative levele, 2013-2017 Abbreviations Data sources *Data on HPV stockouts have only been collected in JRF since 2016 a European Regional Commission for Certification of Poliomyelitis eradication (RCC) meeting report: www.euro.who.int/32ndRCC b European Regional Verification Commission for Measles and Rubella Elimination (RVC) meeting report: www.euro.who.int/7thRVC c European Vaccine Action Plan 2015-2020 Midterm report d WHO/UNICEF Estimates of National Immunization Coverage (WUENIC): (http://www.who.int/immunization/monitoring_surveillance/data/en/) e WHO/UNICEF Joint Reporting Form on immunization (JRF) f World Population Prospects: The 2017 Revision, New York, United Nations g World Bank, World Development Indicators h Polio Laboratory Network: www.euro.who.int/poliolabnetwork & Personal communication based on annual accreditation process of the European Measles and Rubella Laboratory Network i Communication with the country † The boundaries and names shown and the designations used on the maps do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. Map disclaimer AEFI Adverse event following immunization MCV1 measles-mumps-rubella vaccine, first dose BCG Bacille Calmette-Guerin vaccine for tuberculosis MCV2 measles-mumps-rubella vaccine, second dose CRS congenital Rubella Syndrome MMR measles-mumps-rubella vaccine DT diptheria-tetanus-containing vaccine ND Data not available DTP diptheria-tetanus-pertussis-containing vaccine NITAG National Immunization Technical Advisory Group DTP1 diphtheria-tetanus-pertussis-containing vaccine, first dose NR Not relevant as vaccine not included in immunization schedule DTP3 diphtheria-tetanus-pertussis-containing vaccine, third dose OPV oral polio vaccine GNI Gross national income PCV pneumococcal conjugate vaccine HepB hepatitis B PCV3 pneumococcal conjugate vaccine , third dose HepB3 hepatitis B vaccine, third dose Pol3 polio-containing vaccine, third dose HepB-BD hepatitis B vaccine, birth dose RCV1 rubella-containing vaccine, first dose Hib Haemophilus influenzae type b Rotac rotavirus vaccine-complete series Hib3 Haemophilus influenzae type b vaccine, third dose Td tetanus-diphtheria-containing vaccine HPV human papillomavirus TT tetanus toxoid vaccine IPV inactivated polio vaccine W,M,Y Weeks, Months, Years MCV measles-containing vaccine No stockout Subnational level stockout only National level stockout only Stockout at both levels NR ND 2013 2014 2015 2016 2017 BCG No Both ND Both No DTP No Both Both No No HepB No No ND No No Hib No No ND No No Pneumo Both NR NR NR NR Rota NR NR NR NR NR OPV NR NR NR NR NR IPV No No ND No No Measles No No ND No No HPV * * * No ND TT Both Both ND No No ©World Health Organization 2019