Decline of varicella vaccination in German surveillance regions after recommendation of separate first-dose vaccination for varicella and measles-mumps-rubella

Vaccine. 2014 Feb 12;32(8):897-900. doi: 10.1016/j.vaccine.2013.12.065. Epub 2014 Jan 9.


Background: Germany introduced routine varicella (V) vaccination in 2004. Due to a slightly increased risk of febrile convulsions after first-dose application of combined measles-mumps-rubella-varicella (MMRV) vaccine separate first-dose vaccinations with MMR and monovalent V vaccine were recommended in September 2011.

Methods: We compared V and MMR vaccinations in paediatric practices from two surveillance regions (Munich and Würzburg) one year before and after the change in the recommendation.

Results: A total of 1405/326 monthly reports were provided by a monthly average of 79/14 practices participating in Munich/Würzburg. V first-dose vaccinations (monovalent V or MMRV vaccine) declined by 12% in Munich (from 10.1 to 8.9 vaccinations per month and practice; p<0.005) and by 4% in Würzburg (from 9.9 to 9.5; p=0.620), respectively. First-dose vaccinations for MMR (MMR or MMRV vaccine) did not change significantly in both regions.

Conclusion: Acceptance of V vaccination depends in part on the use of combination vaccine.

Keywords: Surveillance; Vaccination; Varicella.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Chickenpox Vaccine / administration & dosage*
  • Child
  • Child, Preschool
  • Germany
  • Humans
  • Immunization Schedule*
  • Infant
  • Measles-Mumps-Rubella Vaccine / administration & dosage*
  • Pediatrics / methods
  • Public Health Surveillance
  • Vaccination / statistics & numerical data*
  • Vaccines, Combined / administration & dosage


  • Chickenpox Vaccine
  • Measles-Mumps-Rubella Vaccine
  • Vaccines, Combined
  • measles, mumps, rubella, varicella vaccine