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... very conservative approach to calculate the response rate [16] and that our responsesrate is comparable to other studies using a similar approach (e.g. CDC-Behavioral Risk FactorsSurveillance System =-=[43]-=-). Considering the complex weighting procedures used in GEDAs2009 and the good cooperation rate (51.2%) it can be assumed that data quality is overallsgood in our study. A further limitation of the st...

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... infections during an average influenza season [4]. In seasonsswith high influenza-activity (e.g. season 1995/1996) it is estimated that there are up to 30,000sexcess deaths attributable to influenza =-=[5, 6]-=-. The German Standing Committee onsVaccination (STIKO) currently recommends seasonal influenza vaccination for the followingstarget groups: (1) persons aged ≥60 years, (2) persons with an underlying c...

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...rvey was anonymous, couldsnot be verified by any medical record documentation. However, self-report of influenzasvaccination status has been previously found to have an adequate degree of reliability =-=[41,s42]-=-, and we only asked for influenza vaccinations in the previous one or two seasons. Onlystelephone landlines were used in the GEDA-Survey. Consequently, people using exclusivelysa mobile phone were not...

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...in any of the targetsgroups.s11/24 4. DiscussionsThe World Health Assembly (WHA) has embarked on the goal of attaining influenzasvaccination coverage of at least 75% in the elderly population by 2010 =-=[19]-=-. Here we presentsvaccination coverage data from two influenza seasons in Germany, which were collected insthe general adult population as well as in high-risk and other target groups by interviewing ...

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...ported to be 24.2% (95%CI 20.7-28.3) [35]. A cross-sectional studyscarried out in 2006 in a large multidisciplinary University hospital in Italy found a vaccinations13/24 coverage of 20.2% among HCWs =-=[32]-=-. Vaccination coverage in US HCWs, which was basedson the findings of a population-based panel survey, was with 61.9% (95%CI 57.5-66.2%)sconsiderably higher [31]. It should be mentioned that the defin...

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...mong healthy adults (aged 16-65syears), parenteral influenza vaccines are 80% efficacious against influenza when there is asgood match between the vaccine components and the circulating virus strains =-=[2]-=-. However,sthe effectiveness of the vaccine depends also on the age and immunocompetence of thesindividual vaccinee [3]. Even though technically feasible, the control of influenza throughsvaccination ...

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...cquisition was conducted via computer-assisted telephonesinterview (CATI) by trained interviewers. The Gabler/Häder sampling design and the lastsbirthday method were used to ensure representativeness =-=[14;15]-=-. Moreover, weighting factorsswere used in order to make the study population comparable to the general population insGermany. The weighting factors were constructed by taking age, gender, educational...

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...e uptake in thesesgroups and to identify better access paths to vaccination.sPrevious studies have consistently found that acceptance of annual influenzasvaccination is considerably higher in the EFS =-=[22, 23]-=-. Significantly higher vaccinations12/24 coverage was also found in our study participants living in the EFS, both in the generalspopulation and in the target groups examined. The reasons for higher v...

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...ions13/24 coverage of 20.2% among HCWs [32]. Vaccination coverage in US HCWs, which was basedson the findings of a population-based panel survey, was with 61.9% (95%CI 57.5-66.2%)sconsiderably higher =-=[31]-=-. It should be mentioned that the definition of “healthcare worker”smay vary in these studies.sVaccination coverage among persons ≥60 years of age was approximately 55% in bothsseasons and was therefo...

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...is asgood match between the vaccine components and the circulating virus strains [2]. However,sthe effectiveness of the vaccine depends also on the age and immunocompetence of thesindividual vaccinee =-=[3]-=-. Even though technically feasible, the control of influenza throughsvaccination poses a great challenge to public health authorities. Current seasonal influenzasvaccines, which usually contain three ...

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...ssurveys conducted among approximately 2000 participants per season revealed a vaccinationscoverage in the chronically ill of 29% in 2003/2004, 27% in 2004/2005, 26% in 2006/2007sand 27% in 2007/2008 =-=[20, 21]-=-. The same surveys revealed also stagnant vaccinationscoverage among HCWs, persons ≥60 years, and in the general adult population [20, 21]. Ins2005/2006 influenza vaccination coverage was, however, hi...

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...e uptake in thesesgroups and to identify better access paths to vaccination.sPrevious studies have consistently found that acceptance of annual influenzasvaccination is considerably higher in the EFS =-=[22, 23]-=-. Significantly higher vaccinations12/24 coverage was also found in our study participants living in the EFS, both in the generalspopulation and in the target groups examined. The reasons for higher v...

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...ality worldwide. ThesWorld Health Organization (WHO) estimates that influenza epidemics result in three to fivesmillion cases of severe illness, and about 250,000 to 500,000 deaths worldwide annually =-=[1]-=-.sInfluenza-related hospitalizations and fatal cases mainly occur among high-risk groups: in thesvery young, elderly, and chronically ill. In industrialized countries most influenza-associatedsdeaths ...

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...ntifiablesproportion of influenza vaccinations is administered by occupational health physicians.sSince 2006, nation-wide seasonal influenza vaccination campaigns are conducted insGermany each season =-=[9]-=-. Unlike other European countries such as Norway, Belgium, and thesNetherlands, Germany has no central immunization register [10]. With the implementation ofsthe ‘German Health Update’ Survey (GEDA) i...

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...al influenza vaccination campaigns are conducted insGermany each season [9]. Unlike other European countries such as Norway, Belgium, and thesNetherlands, Germany has no central immunization register =-=[10]-=-. With the implementation ofsthe ‘German Health Update’ Survey (GEDA) in 2008, a monitoring tool is now available insGermany for the detailed assessment of vaccination coverage in all age-groups above...

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...lso have accesssto high risk groups and can often influence the attitude of their patients towards vaccinations.sNew approaches to enhance vaccine uptake among HCWs in Germany are currentlysdiscussed =-=[29]-=-. Low vaccination coverage among HCWs has been observed not only insGermany but also in several other European and non-European countries [30-39]. Based onsdata gathered in the Spanish National Health...

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...s to vaccination needs tosbe ensured.sIn Germany, an estimated one to five million additional physician consultations aresattributable to influenza virus infections during an average influenza season =-=[4]-=-. In seasonsswith high influenza-activity (e.g. season 1995/1996) it is estimated that there are up to 30,000sexcess deaths attributable to influenza [5, 6]. The German Standing Committee onsVaccinati...

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... infections during an average influenza season [4]. In seasonsswith high influenza-activity (e.g. season 1995/1996) it is estimated that there are up to 30,000sexcess deaths attributable to influenza =-=[5, 6]-=-. The German Standing Committee onsVaccination (STIKO) currently recommends seasonal influenza vaccination for the followingstarget groups: (1) persons aged ≥60 years, (2) persons with an underlying c...

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... to these target groups is free of charge in Germany. Vaccinessare usually administered by private physicians, and reimbursement is provided to thesesphysicians by the statutory health insurance fund =-=[8]-=-. In addition, a small but not quantifiablesproportion of influenza vaccinations is administered by occupational health physicians.sSince 2006, nation-wide seasonal influenza vaccination campaigns are...

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...easons 2007/2008 and 2008/2009.s5/24 2. Methodss2.1. Study populationsGermany has a population of approximately 82 million people, of which 68.3 million (83.3%)sare 18 years of age or older (Table 1) =-=[11]-=-. A total 65.5 million live in the 10 Western FederalsStates (WFS) and 16.5 million live in the 6 Eastern Federal States (EFS) [12]. Our studyspopulation included persons ≥18 years of age living in pr...

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...of which 68.3 million (83.3%)sare 18 years of age or older (Table 1) [11]. A total 65.5 million live in the 10 Western FederalsStates (WFS) and 16.5 million live in the 6 Eastern Federal States (EFS) =-=[12]-=-. Our studyspopulation included persons ≥18 years of age living in private households in Germany andswho were able to be contacted by landline telephone. According to the federal networksagency there ...

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...rivate households in Germany andswho were able to be contacted by landline telephone. According to the federal networksagency there were 38.9 million landline telephones registered in Germany in 2009 =-=[13]-=-.sCriteria for exclusion were age ≤17 years or insufficient knowledge of German language.s2.2. Survey designsData on influenza vaccination coverage in Germany was collected within thesframework of the...

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...different education levels was based on the International StandardsClassification of Education (ISCED 97) as suggested by the United Nations Educational,sScientific and Cultural Organization (UNESCO) =-=[17]-=-. The educational status ‘low’ comprisedsISCED 97 levels 1 and 2, ‘medium’ comprised levels 3 and 4, and ‘high’ comprised levels 5sand 6. To allow comparability among the interviewed persons, househol...

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... household size and age of household members by calculating the net equivalentsincome according to the Organisation for Economic Co-operation and Development (OECD)- modified equivalence scale method =-=[18]-=-. A net equivalent income <70% of the median netsequivalent income in the study sample was classified as ‘low’, those between 70% and 120%sof the median as ‘medium’, and those >120% of the median as ‘...

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...ssurveys conducted among approximately 2000 participants per season revealed a vaccinationscoverage in the chronically ill of 29% in 2003/2004, 27% in 2004/2005, 26% in 2006/2007sand 27% in 2007/2008 =-=[20, 21]-=-. The same surveys revealed also stagnant vaccinationscoverage among HCWs, persons ≥60 years, and in the general adult population [20, 21]. Ins2005/2006 influenza vaccination coverage was, however, hi...

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...many took place over twenty years ago – mandatorysvaccination practices in the former German Democratic Republic still influence today’ssgeneral attitude and behaviour towards vaccinations in the EFS =-=[22, 24]-=-. Moreover,sdifferences in vaccination policies on federal state level can be observed between the easternsand western states. For example, the eastern federal state of Saxony-Anhalt is currently thes...

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... European and non-European countries [30-39]. Based onsdata gathered in the Spanish National Health Survey in 2006, vaccination coverage amongsHCWs in Spain was reported to be 24.2% (95%CI 20.7-28.3) =-=[35]-=-. A cross-sectional studyscarried out in 2006 in a large multidisciplinary University hospital in Italy found a vaccinations13/24 coverage of 20.2% among HCWs [32]. Vaccination coverage in US HCWs, wh...