Alexandra Jablonka1,2, Georg M N Behrens3,4, Marcus Stange5, Christian Dopfer6,7, Ulrike Grote8, Gesine Hansen6,7, Reinhold Ernst Schmidt3,4, Christine Happle6,7. 1. Department of Clinical Immunology and Rheumatology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany. jablonka.alexandra@mh-hannover.de. 2. German Center for Infection Research, Hannover, Germany. jablonka.alexandra@mh-hannover.de. 3. Department of Clinical Immunology and Rheumatology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany. 4. German Center for Infection Research, Hannover, Germany. 5. Department of Paediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany. 6. Department of Pedatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany. 7. German Center for Lung Research, BREATH, Hannover, Germany. 8. Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.
Abstract
BACKGROUND: Current political crises in the Middle East and economic discrepancies led millions of people to leave their home countries and to flee to Western Europe. This development raises unexpected challenges for receiving health care systems. Although pan-European initiatives strive for updated and optimized vaccination strategies, little data on immunity against vaccine-preventable diseases in the current refugee population exist. METHODS: We quantified serum IgG against tetanus and diphtheria (TD) in n = 678 refugees currently seeking shelter in six German refugee centers. FINDINGS: Reflecting current migration statistics in Europe, the median age within the cohort was 26 years, with only 23.9 % of female subjects. Insufficient IgG levels without long-term protection against tetanus were found in 56.3 % of all refugees. 76.1 % of refugees had no long-term protection against diphtheria. 47.7 % of subjects needed immediate vaccination against tetanus, and 47.7 % against diphtheria. For both diseases, an age-dependent decline in protective immunity occurred. INTERPRETATION: We observed a considerably low rate of tetanus-protected refugees, and the frequency of diphtheria-immune refugees was far from sufficient to provide herd immunity. These findings strongly support recent intentions to implement and enforce stringent guidelines for refugee vaccination in the current crisis.
BACKGROUND: Current political crises in the Middle East and economic discrepancies led millions of people to leave their home countries and to flee to Western Europe. This development raises unexpected challenges for receiving health care systems. Although pan-European initiatives strive for updated and optimized vaccination strategies, little data on immunity against vaccine-preventable diseases in the current refugee population exist. METHODS: We quantified serum IgG against tetanus and diphtheria (TD) in n = 678 refugees currently seeking shelter in six German refugee centers. FINDINGS: Reflecting current migration statistics in Europe, the median age within the cohort was 26 years, with only 23.9 % of female subjects. Insufficient IgG levels without long-term protection against tetanus were found in 56.3 % of all refugees. 76.1 % of refugees had no long-term protection against diphtheria. 47.7 % of subjects needed immediate vaccination against tetanus, and 47.7 % against diphtheria. For both diseases, an age-dependent decline in protective immunity occurred. INTERPRETATION: We observed a considerably low rate of tetanus-protected refugees, and the frequency of diphtheria-immune refugees was far from sufficient to provide herd immunity. These findings strongly support recent intentions to implement and enforce stringent guidelines for refugee vaccination in the current crisis.
Authors: Alexandra Jablonka; Christine Happle; Ulrike Grote; Benjamin Thomas Schleenvoigt; Annika Hampel; Christian Dopfer; Gesine Hansen; Reinhold Ernst Schmidt; Georg M N Behrens Journal: Infection Date: 2016-07-22 Impact factor: 3.553
Authors: Annika Hampel; Philipp Solbach; Markus Cornberg; Reinhold E Schmidt; Georg M N Behrens; Alexandra Jablonka Journal: Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz Date: 2016-05 Impact factor: 1.513
Authors: Alexandra Jablonka; Martin Wetzke; Georgios Sogkas; Christian Dopfer; Reinhold Ernst Schmidt; Georg M N Behrens; Christine Happle Journal: J Immigr Minor Health Date: 2018-12
Authors: Britta Höcker; Martin Aguilar; Paul Schnitzler; Lars Pape; Luca Dello Strologo; Nicholas J A Webb; Martin Bald; Gurkan Genc; Heiko Billing; Jens König; Anja Büscher; Markus J Kemper; Stephen D Marks; Martin Pohl; Marianne Wigger; Rezan Topaloglu; Susanne Rieger; Kai Krupka; Thomas Bruckner; Alexander Fichtner; Burkhard Tönshoff Journal: Pediatr Nephrol Date: 2017-10-05 Impact factor: 3.714
Authors: Mireia Jané; Maria José Vidal; Neus Camps; Magda Campins; Ana Martínez; Joan Balcells; Maria Teresa Martin-Gomez; Gloria Bassets; Silvia Herrera-León; Anton Foguet; Mar Maresma; Nuria Follia; Sonia Uriona; Tomàs Pumarola Journal: Euro Surveill Date: 2018-03
Authors: Alexandra Jablonka; Christian Dopfer; Christine Happle; Georgios Sogkas; Diana Ernst; Faranaz Atschekzei; Stefanie Hirsch; Annabelle Schäll; Adan Jirmo; Philipp Solbach; Reinhold Ernst Schmidt; Georg M N Behrens; Martin Wetzke Journal: Int J Environ Res Public Health Date: 2018-06-14 Impact factor: 3.390
Authors: Christian Dopfer; Annabelle Vakilzadeh; Christine Happle; Evelyn Kleinert; Frank Müller; Diana Ernst; Reinhold E Schmidt; Georg M N Behrens; Sonja Merkesdal; Martin Wetzke; Alexandra Jablonka Journal: Int J Environ Res Public Health Date: 2018-09-05 Impact factor: 3.390
Authors: Martin Wetzke; Christine Happle; Annabelle Vakilzadeh; Diana Ernst; Georgios Sogkas; Reinhold E Schmidt; Georg M N Behrens; Christian Dopfer; Alexandra Jablonka Journal: Int J Environ Res Public Health Date: 2018-10-01 Impact factor: 3.390