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. 2024 May;29(18):2300558.
doi: 10.2807/1560-7917.ES.2024.29.18.2300558.

A combined cross-sectional analysis and case-control study evaluating tick-borne encephalitis vaccination coverage, disease and vaccine effectiveness in children and adolescents, Switzerland, 2005 to 2022

Kyra D Zens  1   2 , Ekkehardt Altpeter  3 , Monica N Wymann  3 , Annora Mack  3 , Nora B Baer  1 , Sarah R Haile  4 , Robert Steffen  1 , Jan S Fehr  1 , Phung Lang  1
Affiliations

A combined cross-sectional analysis and case-control study evaluating tick-borne encephalitis vaccination coverage, disease and vaccine effectiveness in children and adolescents, Switzerland, 2005 to 2022

Kyra D Zens et al. Euro Surveill. 2024 May.

Abstract

BackgroundTick-borne encephalitis (TBE) is a severe, vaccine-preventable viral infection of the central nervous system. Symptoms are generally milder in children and adolescents than in adults, though severe disease does occur. A better understanding of the disease burden and duration of vaccine-mediated protection is important for vaccination recommendations.AimTo estimate TBE vaccination coverage, disease severity and vaccine effectiveness (VE) among individuals aged 0-17 years in Switzerland.MethodsVaccination coverage between 2005 and 2022 was estimated using the Swiss National Vaccination Coverage Survey (SNVCS), a nationwide, repeated cross-sectional study assessing vaccine uptake. Incidence and severity of TBE between 2005 and 2022 were determined using data from the Swiss disease surveillance system and VE was calculated using a case-control analysis, matching TBE cases with SNVCS controls.ResultsOver the study period, vaccination coverage increased substantially, from 4.8% (95% confidence interval (CI): 4.1-5.5%) to 50.1% (95% CI: 48.3-52.0%). Reported clinical symptoms in TBE cases were similar irrespective of age. Neurological involvement was less likely in incompletely (1-2 doses) and completely (≥ 3 doses) vaccinated cases compared with unvaccinated ones. For incomplete vaccination, VE was 66.2% (95% CI: 42.3-80.2), whereas VE for complete vaccination was 90.8% (95% CI: 87.7-96.4). Vaccine effectiveness remained high, 83.9% (95% CI: 69.0-91.7) up to 10 years since last vaccination.ConclusionsEven children younger than 5 years can experience severe TBE. Incomplete and complete vaccination protect against neurological manifestations of the disease. Complete vaccination offers durable protection up to 10 years against TBE.

Keywords: Epidemiology; Immunity; Infectious disease; Paediatric vaccination; Switzerland; Tick-borne disease; Tick-borne encephalitis; Vaccine effectiveness.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Flowchart of the study evaluating tick-borne encephalitis vaccination coverage, disease severity and vaccine effectiveness in children and adolescents, Switzerland, 2005–2022
Figure 2
Figure 2
Tick-borne encephalitis vaccination coverage of children and adolescents, by age, Switzerland, 2005–2022 (n = 123,875)
Figure 3
Figure 3
Notified cases of tick-borne encephalitis in children and adolescents, by age and disease severity, Switzerland, 2005–2022 (n = 427)
Figure 4
Figure 4
Vaccine effectiveness against tick-borne encephalitis in children and adolescents, by vaccination status and time, Switzerland, 2005–2022 (n = 463)
See this image and copyright information in PMC

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