Closing MR Immunity Gaps Experiences from AUSTRIA MinRat. Dr. Jean-Paul Klein
Recommendations for MMR-vaccination in Austria Start in 1998: 1 st dose of MMR in the 14 th month of age 2 nd dose of MMR at age of 6 years From 2003: 1 st dose of MMR in the 14 th month of age 2 nd dose of MMR in 2nd year of life, but not earlier than 4 weeks after the first dose From 2004: 1 st dose at 12 month of age 2 nd dose of MMR in 2 nd year of life, but not earlier than 4 weeks after the first dose
Austrian Recommendations 2016 First dose of MMR at the 11 th month of age Second dose as early as possible, but not earlier than 4 weeks after the first dose Missed doses of MMR should be made up for at any time Vaccination recommended for all adults with lack of immunity and missing documentation of 2 doses of MMR vaccine Vaccination is free of charge for everyone at health offices
Vaccine Monitoring 1. Procurement and monitoring of available doses: Procurement by public call for tender 2 years term Possibility 1 year of prolongation Availability secured at any time by monitoring of vaccine stocks Monthly reports by vaccine companies (delivered doses) and health insurance (paid doses) Quarterly report on administered doses by federal states 2. Vaccination coverage: data from 9 federal states: Available on March 1 st of the consecutive year Vaccination year starting on february 1 st ending january 31 st of the next year Standardized report forms 9 federal states, 9 different administrative systems Calculation of coverage rates depends on the quality of reported data
Study on attitudes of the austrian population concernig vaccination Study period 09.10. 16.10.2014 Population Austrian population starting at 16 years of age Region Austria Type of Questioning CAWI (Computer Assisted Web Interviews) Number of subjects n=1.000 Questionnaire Developed by the marketing research institution
2 20 21 very good (1,00) good (2,00) poor (3,00) very poor (4,00) 57 Question 1: In your opinion, to what extent are you informed about possibilities to protect yourself against infectious diseases by the use of vaccines? Angaben in %, Mittelwert
5 4 32 clear overbalance of benefits (1,00) 26 overbalance of benefits (2,00) same amount of benefits and disadvantages (3,00) overbalance of disadvantages (4,00) clear overbalance of disadvantages (5,00) 32 Question 2: What is your general attitude regarding vaccines? Do you believe that vaccines have higher benefits than risks ( for example adverse events)?
5 10 24 22 big threat (1,00) threat (2,00) no real threat (3,00) no threat at all (4,00) don't know, haven't thought about it 40 Question 3: Imagine, you were not vaccinated against measles, would you feel threatend by measles?
National Action Plan for elimination of measles, rubella, and CRS in Austria - 2013
Online: Masern sind kein Kinderspiel! start january 2014 www.bmg.gv.at www.keinemasern.at Posters in public places, City lights, Info Screens in underground stations, museums Teddybärkrankenhaus (Teddy s Hospital) in Innsbruck (folders, posters, balloons) Insertion of measles-banner on TV and online Cooperation with the National Bioethics Committee Joint public panel discussion Ethics and Vaccination (EIW 2014) at the Federal Chancellery Bioethics Committee publication Ethics and Vaccination (to be awaited soon) Information campaigns in selected schools across Austria Measles-Commercial in 30 art-house cinemas across Austria from 11.4. to 1.5.2014 Distribution of info materials at the Baby-Expo (baby fair) in Vienna, 16.-18.5.2014 and at the main National Day event (26.10.2014)
Leaflets and posters
Advertisement in daily newspapers Info-screens (on busses, underground, tram)
Advertising at Leopold Museum, Vienna City-Lights
Distributed doses of MMR 300,000 250,000 200,000 150,000 100,000 50,000 0
Evolution of distributed doses of MMR vaccine in the NIP 250,000 +26%* 200,000 150,000 +12%* +6%* +1%* +19%* 100,000 50,000 0 2010 2011 2012 2013 2014 2015 *compared to distributed number of doses in the preceding year
4.50 Performance of federal states 4.00 3.50 3.00 2.50 2.00 1.50 1.00 0.50 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 0.00 Burgenland Carinthia Lower Austria Upper Austria Salzburg Styria Tyrol Vorarlberg Vienna Österreich
Preliminary effects of the measles campaign Vaccination coverage rates among children of 1 year of age higher than ever 2015 high number of MMR2-doses administered to children of 2-6 years of age 30 000 MMR-vaccinations for catch-up in adults, no information whether MMR1 or MMR2 However, 15.000-30.000 adults with gaps in immunity are protected now
Next steps: Evaluation of vaccination coverage rates cohort model fitted to a dynamic population model Considering distributed numbers of doses administered numbers of doses total number of doses sold in Austria migration measles cases per age groups etc. Aim Evidence-based data, re-evaluate the current vaccination coverage rates in different age groups considering migration evaluate effects of measles campaign identify gaps in immunity Prognosis for different scenarios