Vaccination coverage of children presenting their vaccination card at school entry health examinations. Classification: years, region, vaccinations

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Region: Germany

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Vaccinations	Year (descending)
	2004	2005	2010	2015	2016	2017	2018	2019
Examined children total	722,165	803,875	677,237	692,072	702,549	709,362	703,770	676,325
including with vaccination card	657,170	733,030	626,347	638,642	644,034	649,847	643,176	623,675
Vaccination coverage in percent
Diphtheria	97.3	97.5	95.3	95.3	94.5	93.6	93.1	92.7
Tetanus	97.7	97.8	95.7	95.5	94.8	93.8	93.3	92.9
Pertussis	90.1	91.9	94.7	94.9	94.2	93.2	92.7	92.4
Haemophilus influenzae type B (Hib)	92.1	93.7	93.1	93.3	92.6	91.6	91.4	91.0
Poliomyelitis (IPV)  Info X Print further information on document Inactivated vaccine against the polio virus	94.4	96.2	94.2	94.5	93.9	92.9	92.8	92.3
Hepatitis B	83.6	86.0	86.8	87.6	87.3	86.9	87.2	87.4
Measles
Measles 1. dosis	93.3	94.0	96.4	96.8	97.1	97.1	97.2	97.2
Measles 2 doses	65.7	76.6	91.5	92.8	92.9	92.8	93.1	92.7
Mumps
Mumps 1. dosis	92.6	93.7	96.1	96.5	96.8	96.9	97.0	97.0
Mumps 2 doses	65.2	76.4	91.2	92.6	92.7	92.6	92.9	92.6
German measles
German measles 1. dosis	91.8	93.0	96.1	96.5	96.8	96.9	97.0	97.0
German measles 2 doses	64.4	75.6	91.2	92.6	92.7	92.6	92.9	92.6
Varicella
Varicella 1. dosis	.	.	57.6	87.1	87.8	87.3	88.2	88.9
Varicella 2 doses	.	.	24.2	83.7	84.3	83.7	84.8	85.0
Russian spring-summer (meningo)encephalitis	.	.	37.0	24.6	25.0	23.9	24.4	.
Hepatitis A virus (HAV)	.	.	6.5	.	.	.	.	.
Meningococci C	.	.	69.8	89.3	89.4	89.5	90.0	90.1
Pneumococci	.	.	15.2	86.1	84.4	83.8	83.1	83.4
Rotavirus	.	.	.	.	.	.	32.8	34.5

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Table shows following page dimension(s)		New selection:
Dimension	Current dimension value	List of dimension values
Year		2019 2018 2017 2016 2015 2010 2005 2004
Region	Germany	Germany Baden-Wurttemberg Bavaria Berlin Brandenburg Bremen Hamburg Hesse Mecklenburg Western Pomerania Lower Saxony North Rhine-Westphalia Rhineland-Palatinate Saarland Saxony Saxony Anhalt Schleswig-Holstein Thuringia Former federal territory and East Berlin New Länder excluding East Berlin

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Source(s)/Contact

• Vaccination coverage at school entry health examinations in Germany, Robert Koch Institute (more information on 
  data source/contact person

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  Data Source:	Vaccination coverage at school entry health examinations in Germany
  Contact:
  - Contact Person:	Dr. Thorsten Rieck
  - Department:	Abteilung für Infektionsepidemiologie (Abt. 3), Fachgebiet 33
  - Telephone:	+49 3018 754-3356
  - Fax:	+49 3018 754-3257
  - E-Mail / Contact:	RieckT@rki.de
  Data Owner:	Robert Koch Institute / Robert Koch-Institut [RKI (1)]
  - Street:	Seestraße 10
  - Post Code/Town:	13353 Berlin
  - Telephone:	+49 3018 754-0
  - Fax:	+49 3018 754-2328
  - E-Mail / Contact:	zentrale@rki.de
  - Internet:	http://www.rki.de
  Purpose of Data Collection:	Assessment of vaccination coverage at school entry health examinations in Germany.
  Legal Base:	Protection against Infection Act (IfSG) § 34 (11).
  Data Collector:	Local public health department or commissioned private physicians.
  Reporting Stations:	Local health department via federal state to RKI.
  Object under Review:	Vaccination coverage as documented in vaccination card.
  Interviewees:	Children before school entry.
  Collection:
  - Instruments:	Questionnaire, health examination.
  - Periodicity:	Annual.
  - First:	According to IfSG the aggregated and anonymised data have to be reported to RKI since 2001.
  - Last:	Not applicable.
  Processing:
  - Periodicity:	Annual.
  Publication:
  - Regular:	Annual in Epidemiological Bulletin in summer.
  - Irregular:	-
  Completeness, Sample Proportion and Representativity:	Complete and representive collection of data of all children before school entry, vaccination coverage is estimated for children presenting with vaccination card.
  Conceivable Modifications:	No age cohort because age at school entry and time of school entry examination vary in the 16 federal states, no data of vaccination status of children without vaccination card.
  Comparable Data Sources:	None.
  Remarks:	-
  Last Update:	May 13, 2024

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  Data owner: Robert Koch Institute

   

  Vaccination coverage at school entry health examinations in Germany

   

  The vaccination data of children are documented within the school entry health examinations according to § 34 Abs. 11 IfSG by the health offices or authorized doctors, transferred to the regional offices in aggregated form and provided to the Robert Koch Institute, where the data are centrally recorded and evaluated. Because the survey in the individual federal Länder takes place with different methods, the Robert Koch Institute has set up definitions for completed or begun series of vaccination and developed a common questionnaire, which presents itself since the school entrance examinations 2012 as follows: Because for basic immunization of children combination vaccines are mainly used, for diphtheria, tetanus, pertussis, hib, poliomyelitis and hepatitis b respectively four vaccinations are defined as completed basic immunization or for hib, poliomyelitis and hepatitis b three vaccinations when using monovalent vaccines. For measles, mumps, rubella and varicella vaccinations recording is differentiated into at least one vaccination and two vaccinations. The pneumococci vaccination is recommended by the permanent vaccination commission (STIKO) only until the end of the second year of life. For a complete pneumococci vaccination series, depending on the age, one to four vaccinations (age at first vaccination

  • 2 to 6 months: at least 4 vaccinations;
  • 7 to 11 months: at least 3 vaccinations;
  • 12 to 23 months: at least 2 vaccinations;
  • 24 months and older: at least one vaccination) are necessary;

  alternatively the application of at least 2 vaccine doses will be considered as complete series of vaccination regardless of the age. In case of vaccination against meningococcus C one vaccination is enough. New was the inclusion of the rotavirus vaccination into the questionnaire, which is complete with two (by using the vaccine Rotarix®) or three vaccinations (vaccine RotaTeq®) and is alternatively recorded as "at least 2 vaccinations". For vaccination against tick-borne (meningo)encephalitis three vaccinations are considered as complete vaccination series.

   

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Definition(s)

• Diphtheria

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  In terms of the Notifiable Infectious Diseases - data collection by Robert Koch Institute:
  The typical image is that of a severe pharyngitis caused by toxin producing bacteria of the type Corynebacterium diphtheriae. The bacteria can also occur in wounds (skin diphtheria). It is mainly transmitted by droplets. Diphtheria can be prevented by vaccination.

  Hepatitis A

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  In terms of the Notifiable Infectious Diseases - data collection by Robert Koch Institute:
  The hepatitis A virus is excreted via faeces and transmitted via direct contact, contaminated food or drinking water. It causes an acute inflammation of the liver. In countries with low hygiene standards the infection rate is already very high in childhood. In Europe and North America in the last decades a continuous decline of the disease frequency occurred, so that here fewer and fewer juveniles and adults have immunity. A vaccine is available.

  Hepatitis B

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  In terms of the Notifiable Infectious Diseases - data collection by Robert Koch Institute:
  Hepatitis B is an inflammation of the liver that occurs world-wide in humans and is caused by the hepatitis B virus. It is mainly transmitted sexually or by blood. In adults, it mostly heals up, but in 5 to 10 % of the cases it can become chronical and result in liver cirrhosis or liver cancer. There is an effective vaccination.

  Hib

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  In terms of the Notifiable Infectious Diseases - data collection by Robert Koch Institute:
  Bacteria of the type haemophilus influenzae cause especially invasive diseases like inflammations of the cerebral membrane, the epiglottis, the bone and muscular tissue as well as sepsis. Disease transmission takes place via droplets or direct contact. In Germany a vaccination in the suckling or toddler age against the capsule type b is recommended.

  IPV

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  In terms of the Notifiable Infectious Diseases - data collection by Robert Koch Institute:
  Poliomyelitis, also named spinal polio, is caused by polio virus, which is excreted by infected persons via faeces. Disease transmission takes place by direct contact, a disease transmission via droplets is also possible. Since 1998, the oral polio vaccine (OPV) is no longer used for vaccination, but the inactivated vaccine (IPV).

  Measles

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  In terms of the Notifiable Infectious Diseases - data collection by Robert Koch Institute:
  Measles is a highly infectious virus disease, which only occurs in humans. It is transmitted by air and is characterised by fever, inflammation of the upper respiratory tract and a typical rash. Dreaded are complications like otitis media, lung or cerebral inflammation. Vaccinations offer an effective protection against measles. The eradication of measles is a proclaimed aim of the German health policy. To reach this goal 95% of all children must be vaccinated twice.

  Meningococci, invasive disease

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  In terms of the Notifiable Infectious Diseases - data collection by Robert Koch Institute:
  Meningococci are bacteria of the Neisseria meningitidis. They are transmitted by droplets and arouse an acute, partly hyperacute disease, which mostly manifests as meningitis or also primary meningococcal sepsis. The lethality is 5 to 10 %. Meningococci are divided into different sero groups, of which exclusively the serogroups B and C occur in Germany.

  Tick-borne encephalitis, also Russian spring-summer (meningo)encephalitis

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  In terms of the Notifiable Infectious Diseases - data collection by Robert Koch Institute:
  The tick-borne encephalitis (TBE), also russian spring-summer (meningo)encephalitis is caused by the TBE/RSSE-Virus, which is transmitted by ticks to humans. Approximately 30% of the infections proceed symptomatically, after an incubation time from 7 to 14 days flu-like symptoms occur. In up to 10% of the infections this is followed by the specific symptoms of TBE with affection of the central nervous system, namely meningitis, encephalitis or myelitis. Available inactivated vaccine offers an effective protection against TBE.

Comment(s)

• In 2008 and 2009, in all federal Länder excluding Bremen and North Rhine-Westphalia the collection took place with a new survey method (completed initial immunization = 4 vaccination doses for diphtheria, tetanus, pertussis, Hib, poliomyelitis and hepatitis b if vaccines with pertussis component were used.)
  In 2012, the vaccination coverage of pneumococci vaccination in the federal Länder Baden-Wurttemberg, Hamburg, Hesse, Mecklenburg Western Pomerania, North Rhine-Westphalia, Schleswig-Holstein and Thuringia refers to the application of at least two vaccinations. In the federal Länder Hamburg, Hesse, Schleswig-Holstein and Thuringia, the vaccination coverage of poliomyelitis, haemophilus influenzae type B and hepatitis B refers to the application of at least four vaccinations.
  In 2013, the vaccination coverage of pneumococci vaccination in the federal Länder Baden-Wurttemberg, Hamburg, Hesse, North Rhine-Westphalia, Schleswig-Holstein and Thuringia refers to the application of at least two vaccinations. In the federal Länder Baden-Wurttemberg, Hamburg, Hesse, North Rhine-Westphalia, Schleswig-Holstein and Thuringia, the vaccination coverage of poliomyelitis, haemophilus influenzae type B and hepatitis B refers to the application of at least four vaccinations.
  In 2014, the vaccination coverage of pneumococci vaccination in the federal Länder Baden-Wurttemberg, Hamburg, Hesse, North Rhine-Westphalia, Schleswig-Holstein and Thuringia refers to the application of at least two vaccinations. In the federal Länder Baden-Wurttemberg, Hamburg, Hesse, Schleswig-Holstein and Thuringia, the vaccination coverage of poliomyelitis, haemophilus influenzae type B and hepatitis B refers to the application of at least four vaccinations.
  In 2015, the vaccination coverage of pneumococci vaccination in the federal Länder Baden-Wurttemberg, Bremen, Hamburg, Hesse, Schleswig-Holstein and Thuringia refers to the application of at least two vaccinations. In the federal Länder Baden-Wurttemberg, Hamburg, Hesse, Schleswig-Holstein and Thuringia, the vaccination coverage of poliomyelitis, haemophilus influenzae type B and hepatitis B refers to the application of at least four vaccinations.
  In 2016 , the vaccination coverage of pneumococci vaccination in the federal Länder Baden-Wurttemberg, Bremen, Hamburg, Hesse, North Rhine-Westphalia, Schleswig-Holstein and Thuringia refers to the application of at least two vaccinations. In the federal Länder Baden-Wurttemberg, Thuringia, Hamburg and Schleswig-Holstein the vaccination coverage of poliomyelitis, haemophilus influenzae type B and hepatitis B refers to the application of at least four vaccinations. The vaccination coverage of rotavirus vaccination in the federal Länder Berlin, Saarland, Schleswig-Holstein, Thuringia refers to the application of at least two vaccinations.
  In 2017, the vaccination coverage of pneumococci vaccination in the federal Länder Baden-Wurttemberg, Bremen, Hamburg, Hesse, Schleswig-Holstein and Thuringia refers to the application of at least two vaccinations. In the federal Länder Baden-Wurttemberg, Hesse, Thuringia, Hamburg and Schleswig-Holstein the vaccination coverage of poliomyelitis, haemophilus influenzae type B and hepatitis B refers to the application of at least four vaccinations. The vaccination coverage of rotavirus vaccination in the federal Länder Berlin, Saarland, Schleswig-Holstein and Thuringia refers to the application of at least two vaccinations.
• In 2008, children at the age of 5 to 6 are covered in Baden Wurttemberg and children at the age of 5 to 8 in Saarland.
  In 2009, Baden-Wurttemberg used data of 4 to 5 year-old children, who were examined in 2009 and who started school in 2009 or 2010.
  In 2010, Baden-Wurttemberg used data of 5 year-old children, who were examined in the school year 2009/2010 and who should start school by the reference day regulation 2011.
  In 2011, Baden-Wurttemberg used data of 4 to 5 year-old children, who were examined in the school year 2010/2011 and who should start school by the reference day regulation 2012.
  In 2012, Baden-Wurttemberg used data of 4 to 5 year-old children, who were examined in the school year 2011/2012 and who should start school by the reference day regulation 2013.
  In 2013, Baden-Wurttemberg used data of 4 to 5 year-old children, who were examined in the school year 2012/2013 and who should start school by the reference day regulation in 2014.
  In 2014, Saxony Anhalt used data of 4 to 5 year-old children, who were examined in 2014 and who should start school at least in 2015.
  In 2015, Saxony Anhalt used data of 4 to 5 year-old children, who were examined in 2015 and who should start school at least in 2016. Baden-Wurttemberg used data of 4 to 5 year-old children, who were examined in the school year 2014/2015 and who should start school by the reference day regulation in 2016.
  In 2016, Saxony Anhalt used data of 4 to 5 year-old children, who were examined in 2016, and who should start school at least in 2017. Baden-Wurttemberg used data of 4 to 5 year-old children, who were examined in the school year 2015/2016 and who should start school by the reference day regulation in 2017.
  In 2017, Saxony Anhalt used data of 4 to 5 year-old children, who were examined in the school year 2017 and who should start school at least in 2018. Baden-Wurttemberg used data of 4 to 5 year-old children, who were examined in the school year 2016/2017 and who should start school by the reference day regulation in 2018.
  Starting from the school entry health examination 2013 in Berlin and starting from 2017 in Thuringia the data are based on the first-time examined children; previously the data were based on the children who started school in the respective year (that means including the children, who were deferred in the previous year).
  In Bavaria, children with the information that they have been living in Germany for less than 1 year have not been part of the children examined here since the school entrance examinations in 2016.
• In 2004, there are no values available for Rhineland Palatinate and Saxony. The values of these Laender are therefore not included in the result of Germany. In 2004, the values for Hamburg are based on a sub sample of 70 % of the children, who were enrolled in school.
• In Hamburg, the vaccination rates for the first vaccination against measles, mumps, rubella and varicella as well as the meningococcal C vaccination cannot be recorded for the 2017 school entrance examinations. Lower Saxony cannot provide any pneumococcal vaccination rates for the 2017 school entrance examinations.
• For the calculation of the hepatitis b vaccination coverage, in 2008 the data of Hesse and Thuringia and in 2009 the data of Bremen, Schleswig-Holstein and Thuringia were formed by an average between 3 and 4 vaccination doses.

Refresh period of data

• The table was extended by the year 2019 on 22 Feb 2022.
  Information for a new reporting period will be added as soon as it is available.

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• .   = Data unknown or confidential

The Federal Health Monitoring System 4. Dec 2024