Tick-borne encephalitis vaccination in persons with a recent history of Lyme borreliosis: Insights from a Knowledge, Attitudes and Behaviour survey in Bavaria, Germany

IF 3.1 2区医学 Q2 INFECTIOUS DISEASES

Ticks and Tick-borne Diseases Pub Date : 2025-02-07 DOI:10.1016/j.ttbdis.2025.102445

Stefanie Böhm , Andreas Beyerlein , Volker Fingerle , Merle M. Böhmer , Manfred Wildner

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引用次数: 0

Abstract

Tick-borne encephalitis (TBE) frequently causes severe disease or even long-term sequelae, especially in adults. In Germany, TBE risk areas are defined based on historical TBE incidences at the district level and are updated yearly. Meanwhile, almost all Bavarian districts are designated risk areas. TBE vaccination is recommended for residents or visitors of these risk areas. However, recent evidence indicates that only around one fifth of adults and one third of children and adolescents are vaccinated against TBE. Most persons notified with TBE (>97 %) are found to be not or insufficiently vaccinated. Our study aimed to identify the reasons for and against TBE vaccination among persons at high risk for tick-borne diseases (TBD) based on recent diagnosis of Lyme borreliosis (LB) to inform future preventive measures.

We invited persons with a recent course of LB notified between June and August 2019 to complete a self-reported questionnaire about their knowledge, attitudes and behaviours regarding TBD-related themes. We examined self-reported TBE vaccination status using different categories based on the number of doses received.

Information on their TBE vaccination status was provided by 366 of 376 eligible participants, of whom 249 (68 %) reported to have been vaccinated. Of 228 participants who provided further details, 142 (62 %) reported to have received a regular booster vaccination. Apart from age category and TBD-specific knowledge level, vaccination status was not associated with any other sociodemographic or residence-specific factors, outdoor behaviours, occupational exposure, or prior experiences with ticks or TBDs. Main reasons for vaccination were living in a TBE risk area, spending time in tick-prone environments and recommendation by a physician. Main barriers were vaccine scepticism, fear of side effects, not having given TBE vaccination any thought and low risk perception.

These results suggest that in order to achieve a higher vaccination coverage to prevent TBE cases, awareness about TBE risk areas and the recommended vaccination need to be raised. Addressing misconceptions and increasing trust in vaccine safety appears crucial to address perceived barriers. Engaging trusted sources, such as medical professionals, and both implementing broad public campaigns and focusing on high-risk groups are key strategies for increasing vaccination uptake.

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在最近有莱姆病和疏螺旋体病病史的人群中接种蜱传脑炎疫苗：来自德国巴伐利亚州一项知识、态度和行为调查的见解

蜱传脑炎（TBE）经常引起严重疾病甚至长期后遗症，特别是在成人中。在德国，根据地区一级的历史脑炎发病率定义脑炎危险区，并每年更新一次。与此同时，几乎所有巴伐利亚地区都被指定为危险地区。建议对这些危险地区的居民或访客接种乙脑疫苗。然而，最近的证据表明，只有大约五分之一的成年人和三分之一的儿童和青少年接种了破伤风疫苗。大多数被通报患有脑炎的人（97%）没有或没有充分接种疫苗。我们的研究旨在根据最近的莱姆病（LB）诊断，确定蜱传疾病（TBD）高危人群接种TBE疫苗的原因和反对原因，为未来的预防措施提供信息。我们邀请了最近在2019年6月至8月期间接受过LB课程的人员完成一份自我报告问卷，了解他们对tbd相关主题的知识、态度和行为。我们根据接受的剂量数量使用不同的类别检查了自我报告的TBE疫苗接种状况。376名符合条件的参与者中有366人提供了有关其TBE疫苗接种状况的信息，其中249人（68%）报告已接种疫苗。在提供进一步细节的228名参与者中，142名（62%）报告接受了定期加强疫苗接种。除年龄类别和tbd特定知识水平外，疫苗接种状况与任何其他社会人口学或居住特定因素、户外行为、职业暴露或蜱虫或tbd既往经历无关。接种疫苗的主要原因是生活在TBE风险地区，在蜱虫易发的环境中度过时间以及医生的建议。主要障碍是对疫苗的怀疑，对副作用的恐惧，没有考虑过疫苗接种和低风险认知。这些结果表明，为了实现更高的疫苗接种覆盖率以预防TBE病例，需要提高对TBE危险区域和推荐疫苗接种的认识。消除误解和增加对疫苗安全的信任似乎对于解决感知到的障碍至关重要。利用可信赖的来源，如医疗专业人员，开展广泛的公共运动和重点关注高危群体，是提高疫苗接种率的关键战略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ticks and Tick-borne Diseases INFECTIOUS DISEASES-MICROBIOLOGY

CiteScore

6.90

自引率

12.50%

发文量

185

审稿时长

6-12 weeks

期刊介绍： Ticks and Tick-borne Diseases is an international, peer-reviewed scientific journal. It publishes original research papers, short communications, state-of-the-art mini-reviews, letters to the editor, clinical-case studies, announcements of pertinent international meetings, and editorials. The journal covers a broad spectrum and brings together various disciplines, for example, zoology, microbiology, molecular biology, genetics, mathematical modelling, veterinary and human medicine. Multidisciplinary approaches and the use of conventional and novel methods/methodologies (in the field and in the laboratory) are crucial for deeper understanding of the natural processes and human behaviour/activities that result in human or animal diseases and in economic effects of ticks and tick-borne pathogens. Such understanding is essential for management of tick populations and tick-borne diseases in an effective and environmentally acceptable manner.