TIP implementation in Germany
The persistence of measles outbreaks in Germany, and particularly unexplained immunization gaps in some southern districts, have caused ongoing concern among local public health authorities. To close these gaps, prevent future outbreaks and contribute to the elimination of measles and rubella in Germany and the WHO European Region, regional public health authorities in Baden-Wurttemberg have initiated a tailoring immunization programmes (TIP) project.
As a first step, an orientation and stakeholder meeting was held to obtain an overview of routine immunization in Germany and discuss various approaches to the TIP project. A situation analysis was conducted based on vaccination coverage data, data from past outbreaks of vaccine-preventable diseases and regional specificities, including the existence of susceptible subpopulations, as well as likely supply- and demand-side barriers and motivators to vaccination. Based on available epidemiological data, the group of experts agreed to focus on measles, mumps and rubella vaccination in specified districts.
During the subsequent formative research phase, 3 questionnaire-based substudies were conducted to further explore these barriers with various target groups:
- parents of preschool children, used to identify determinants related to their intention to immunize children against measles, mumps and rubella;
- social medical assistants and paediatricians, used to explore parental barriers to vaccination, as assessed by these health professionals; and
- general practitioners used to explore determinants related to vaccine hesitancy in this group of health workers.
Next steps include a stakeholder meeting to discuss conclusions from the research conducted, to identify initial tailored service delivery solutions and to explore potential additional research needs, at state and federal levels.
