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Decision-making process and impact of implementation of hexavalent vaccines in immunisation programmes: the case of Germany Wolfgang Jilg Institute for Medical Microbiology and Hygiene University of Regensburg, Germany. STIKO = Ständige Impfkommission.
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Decision-making process and impact of implementation of hexavalent vaccines in immunisation programmes: the case of Germany Wolfgang Jilg Institute for Medical Microbiology and Hygiene University of Regensburg, Germany
STIKO = Ständige Impfkommission • board of experts appointed by the German Ministry of Health • makes recommendations on vaccination for the German states • recommendations made by the STIKO generally accepted as guidelines • vaccinations recommended by STIKO are usually paid by the insurances
STIKO recommendations and hexa-valent vaccines • no specific recommendation for combined vaccines other than DT or Td • general recommendation, that combined vaccines should be used “.... whenever possible and applicable”
Mu D Me D Pa Mu Ru Me T T D T T T T T Hib D Pa Hib D Pa Hib IPV D Pa D Pa IPV IPV HB Hib HB Hib Combined vaccines for infants available in Germany
Recommendations of STIKO for vaccination of infants and adolescents(STIKO 2001) age vaccines 2 months DTPa Hib IPV HB 3 months DTPa (Hib) (IPV) (HB) 4 months DTPa Hib IPV HB 11-14 months DTPa Hib IPV HB MMR MMR 15-23 months 4- 5 years DT/Td MMR** 9-17 years Td, Pa IPV 3xHB* * when not vaccinated in infancy ** when not vaccinated so far or only once
How are hexavalent vaccines accepted in Germany? • no data available so far • personal impression: pentavalent vaccines plus additional hepatitis B vaccine still preferred, but use of hexavalent vaccine increases slowly
Reasons impeding the implementation of hexavalent vaccines • lack of additional reimbursement for the doctor when using combined vaccines • fear of exhaustion of the immune system (by parents/vaccinees and some doctors!)
What can we do to improve the use of hexavalent vaccines in Germany? • better the situation regarding reimbursement of doctors when using combined vaccines • inform doctors and parents about the advantages and the safety of combined, esp. hexavalent vaccines