Vaccination coverage rates of military personnel worldwide: a systematic review of the literature

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Abstract

Objectives

Due to the professionally specific risk of infection in the armed forces, recommendations for vaccination are usually adapted for soldiers and are subject to special regulations. Little data is available on scientifically measured vaccination coverage of soldiers.

Methods

A systematic literature research was carried out in the PubMed database using the search terms “army” or “military” or “Bundeswehr” and “vaccination” or “vaccine”. Studies covering the period from 1990 to 2018 that contain statements on vaccination coverage rates of soldiers were identified. Twenty-two out of the initially found 1801 results were used.

Results

The studies found were conducted in nine different countries with eight out of the 22 studies originating from the USA. The size of study was between 180 and 32,502 subjects. On average, the vaccination rates determined in the studies were between 26.8 and 94.7%. Hepatitis A coverage was lowest (a minimum of 11.3%) and tetanus vaccination coverage was highest (with a maximum of 94.7%). Vaccination rates decreased with increasing age and coverage tended to be lower for men than for women. The term of service did not have a significant effect on vaccination rates.

Conclusions

On the whole, most studies referred to recruits. They showed high vaccination rates for standard vaccinations and lower vaccination rates for indication and seasonal vaccinations. However, there were also vaccination gaps of temporary-career volunteers. This leads to a considerable effort at the armed forces to complete vaccine protection in case of a short-term operational commitment.

Related collections

Most cited references 31

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The term "herd immunity" is widely used but carries a variety of meanings. Some authors use it to describe the proportion immune among individuals in a population. Others use it with reference to a particular threshold proportion of immune individuals that should lead to a decline in incidence of infection. Still others use it to refer to a pattern of immunity that should protect a population from invasion of a new infection. A common implication of the term is that the risk of infection among susceptible individuals in a population is reduced by the presence and proximity of immune individuals (this is sometimes referred to as "indirect protection" or a "herd effect"). We provide brief historical, epidemiologic, theoretical, and pragmatic public health perspectives on this concept. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.

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[Vaccination coverage in German adults: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

C Poethko-Müller, Kelli R. Schmitz (2013)

In the absence of an immunisation register, vaccination coverage in Germany must be estimated. Ten years after the German National Health Interview and Examination Survey 1998 (GNHIES98), the population survey DEGS1 is one of the data sources to be used for monitoring vaccination coverage. In the survey, data on vaccination history were obtained from vaccination cards and self-reports. The prevalence of immunisation for tetanus and diphtheria was higher compared to the prevalence estimated ten years previously in GNHIES98. Nonetheless, 28.6 % of adults have not been vaccinated against tetanus and 42.9 % have not been vaccinated against diphtheria within the last ten years. Vaccination is especially low among the elderly, among adults with low socio-economic status and in western Germany. During the last ten years, only 11.8 % of women and 9.4 % of men were vaccinated against pertussis in western Germany; vaccination coverage was twice as high in eastern Germany. In 2009, recommendations were published to combine the next tetanus immunisation with a pertussis immunisation; therefore pertussis vaccination coverage might improve in the coming years. The lifetime prevalence of influenza vaccination obtained in DEGS1 is higher than the annual vaccination rate for influenza. However, the lifetime prevalence among adults aged 60 years or older is still below the annual rate of 75 % recommended by the WHO. An English full-text version of this article is available at SpringerLink as supplemental.

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Prevaccination screening of health-care workers for immunity to measles, rubella, mumps, and varicella in a developing country: What do we save?

Emine Alp, Fatma Cevahir, Selma Gökahmetoğlu … (2012)

A structured questionnaire was administered to health-care workers (HCWs). The HCWs were also screened for measles, rubella, mumps, and varicella (MMRV) using serological methods. One thousand two hundred and fifty-five HCWs were tested. Of the HCWs examined, 94% were immune to measles, 97% to rubella, 90% to mumps and 98% to varicella. The positive predictive values of histories of measles, mumps, rubella and varicella were 96%, 93%, 100% and 98%, respectively. The negative predictive values of histories of measles, mumps, rubella and varicella were 13%, 17%, 5% and 2%, respectively. The cost of vaccination without screening was significantly more expensive (cost difference: €24,385) for varicella, although vaccination without screening was cheap (cost difference: €5693) for MMR. Although the use of cheaper vaccines supports the implementation of vaccination programs without screening, the cost of vaccination should not be calculated based only on the direct costs. The indirect costs associated with lost work time due to vaccination and its side effects and the direct costs of potential side effects should be considered. However, if prescreening is not conducted, some HCWs (2-7%) would be unprotected against these contagious illnesses because of the unreliability of their MMRV history. In conclusion, the screening of HCWs before vaccination continues to be advisable. Copyright © 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

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Author and article information

Contributors

Stefan Sammito:

ORCID: http://orcid.org/0000-0001-5605-1040

stefansammito@bundeswehr.org

Journal

Journal ID (nlm-ta): Int Arch Occup Environ Health

Journal ID (iso-abbrev): Int Arch Occup Environ Health

Title: International Archives of Occupational and Environmental Health

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 0340-0131

ISSN (Electronic): 1432-1246

Publication date (Electronic): 19 June 2020

Publication date PMC-release: 19 June 2020

Publication date (Print): 2021

Volume: 94

Issue: 1

Pages: 1-8

Affiliations

[1 ]GRID grid.452235.7, ISNI 0000 0000 8715 7852, Bundeswehr Hospital Hamburg, ; Hamburg, Germany

[2 ]GRID grid.5807.a, ISNI 0000 0001 1018 4307, Occupational Medicine, , Otto-Von-Guericke University Magdeburg, ; Magdeburg, Germany

[3 ]Medical Clinic Rotenburg, Rotenburg, Germany

[4 ]Air Force Centre of Aerospace Medicine, Department I 3, Flughafenstraße 1, 51147 Cologne, Germany

Author information

Stefan Sammito http://orcid.org/0000-0001-5605-1040

Article

Publisher ID: 1559

DOI: 10.1007/s00420-020-01559-w

PMC ID: 7826299

PubMed ID: 32561973

SO-VID: dec7050b-bf0a-4601-ad2d-24eb84c2d26c

License:

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