Routine immunization profile: Germany

Routine immunization profile Germany 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 Yes ND 2 Measles elimination statusb Endemic 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 Yes YesRubella elimination status b Endemic 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 82 114 224 Live births 724 607 Surviving infants 722 969 <5 years 3 595 119 <15 years 10 736 390 Neonatal mortality rate (per 1000 live births)f 2.2 Infant mortality rate (per 1000 live births)f 3.1 Number of districtse 402 GNI (per capita, in USD)g 43 700 Health spending as % of total government expenditureg 21 Immunization schedule, 2017e 6W Rotavirus 2M DTaP, DTaPHibHepBIPV,DTaPHibIPV, HepB_Pediatric, PCV 10W Rotavirus 3M DTaP, DTaPHibHepBIPV, DTaPHibIPV 4M DTaP, DTaPHibHepBIPV, DTaPHibIPV, HepB_Pediatric, PCV 11-14M DTaP, DTaPHibHepBIPV, DTaPHibIPV, HepB_Pediatric, MMR, PCV, Varicella 11-23M MenC_conj 15-23M MMR, MMRV, Varicella 5-7Y TdaPIPV 9-14Y HPV(2x) 9-17Y DTaPIPV, TdaPIPV Routine immunization profile Germany Vaccine coverage estimates, 2013-2017d Number of reported cases of vaccine- preventable diseases, 2013-2017e,i 2013 2014 2015 2016 2017 Measles 1771 443 2464 326 929 Mumps ND 837 699 741 652 Rubella ND 151 90 95 74 Congenital rubella syndrome 1 0 0 0 0 Diphtheria 4 9 14 9 11 Tetanus ND ND ND ND ND Pertussis ND 12 260 9000 13 809 16 183 Hepatitis A 779 681 856 736 1232 Varicella ND 22 128 23 130 25 027 22 206 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,i Measles Yes Rubella Yes Congenital rubella syndrome Yes Rotavirus Yes Invasive meningococcal disease Yes Invasive pneumococcal disease No 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 NR NR NR NR NR HepB-BD NR NR NR NR NR DTP1 99 99 99 99 99 DTP3 95 95 95 95 95 HepB3 87 87 87 87 87 Hib3 93 93 93 93 93 Pol3 94 94 94 94 94 PCV3 84 84 84 84 84 Rotac NR 67 68 68 68 RCV1 97 96 97 97 97 MCV1 97 97 97 97 97 MCV2 93 93 93 93 93 Routine immunization profile Germany 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 DTP4 doses administered and DTP4 reported coveragee, 2013-2017 Number of reported diphtheria, tetanus and pertussis casese,i 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 Yes 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 No 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 0 20 40 60 80 100 0 500 1000 1500 2000 2500 3000 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 2000 4000 6000 8000 10000 12000 14000 16000 18000 2013 2014 2015 2016 2017 % c ov er ag e N um be r o f c as es Year Diptheria Tetanus (ND) Pertussis DTP3 coverage 0 20 40 60 80 100 0 100000 200000 300000 400000 500000 600000 700000 2013 2014 2015 2016 2017 % c o ve ra ge N u m b er Year DTP4 reported target DTP4 reported doses DTP4 reported coverage 100 100 100 100 100 0 20 40 60 80 100 2013 2014 2015 2016 2017 Percentage of subnational areas Ye ar ≥90% 80-89% 50-79% <50% ND 4 4 4 4 4 0 1 2 3 4 5 2013 2014 2015 2016 2017 DTP1-DTP3 dropout rate (%) Ye ar Routine immunization profile Germany 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 MCV measles-containing vaccine BCG Bacille Calmette-Guerin vaccine for tuberculosis MCV1 measles-mumps-rubella vaccine, first dose CRS congenital Rubella Syndrome MCV2 measles-mumps-rubella vaccine, second dose DT diptheria-tetanus-containing vaccine MMR measles-mumps-rubella vaccine DTP diptheria-tetanus-pertussis-containing vaccine ND Data not available DTP1 diphtheria-tetanus-pertussis-containing vaccine, first dose NITAG National Immunization Technical Advisory Group DTP3 diphtheria-tetanus-pertussis-containing vaccine, third dose NR Not relevant as vaccine not included in immunization schedule DTP4 diphtheria-tetanus-pertussis-containing vaccine, fourth 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 No stockout Subnational level stockout only National level stockout only Stockout at both levels NR ND 2013 2014 2015 2016 2017 BCG NR NR NR NR NR DTP ND ND No ND No HepB ND ND No No No Hib ND ND No No No Pneumo ND ND No No No Rota ND ND No No No OPV NR NR NR NR NR IPV ND ND No ND No Measles ND ND No No No HPV * * * No No TT ND ND ND No No ©World Health Organization 2019