Presentation (CTI)

OBJECTIVES: Despite clear national recommendations by the Standing Committee on Vaccination (STIKO) and a structured program of preventive health check-ups, timely infant vaccination rates for pneumococcal conjugate vaccination (PCV) and hexavalent vaccination (HEXA) in Germany remain suboptimal. In particular, booster dose uptake lags behind initial doses, contributing to gaps in early childhood immunity. We aim at assessing the vaccination uptake and timeliness in infants in Germany, focusing on full-series completion rates and the extent to which preventive health check-ups are utilized for on-schedule infant immunizations.
METHODS: We conducted a retrospective claims analysis using German statutory-health-insurance data, including all infants born in 2022 with 24 months follow-up. We determined full vaccination rates for PCV and hexavalent vaccines (2+1 series for term infants, 3+1 for preterm). Vaccination status categories (full series, primary series, partially vaccinated, unvaccinated) and timeliness relative to recommended schedules were computed. We evaluated co-administration patterns and overlap with scheduled preventive health check-ups (at months 3-4, 6-7, 10-12, or 21-24).
RESULTS: Overall, 78% of infants completed the full PCV series by 24 months; an additional 12% received the primary series only (no booster), 2% were partially vaccinated, and 8% remained unvaccinated. Coverage for HEXA was similar (79%, 11%, 2%, 8%, respectively). Only 18% (19%) of booster PCVs (HEXA) were administered during one of the preventive health check-ups.
CONCLUSIONS: National claims data reveal that approximately 1 in 5 infants do not receive their PCV/HEXA booster by age 2, leaving gaps in protection. Preventive health check-ups are a suboptimal but promising platform for vaccinations - currently fewer than 1 in 5 booster doses are delivered during preventive health check-ups, even though many undervaccinated children attend these visits. Better integration of immunizations into scheduled preventive health check-ups (e.g. delivering PCV/HEXA boosters at U6/U7 examinations) could significantly increase timely vaccine series completion in early childhood.