Lessons to be learnt from other countries about mandatory child vaccination

Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.
BMJ (online) (Impact Factor: 17.45). 06/2012; 344:e4036. DOI: 10.1136/bmj.e4036
Source: PubMed
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    ABSTRACT: European public health systems are converging, particularly in relation to communicable disease control. This process requires mutual learning through comparison; this was undertaken for Scotland (population 5.1 million) and Hungary (population 10.5 million). Using the official web- and paper-based publications, the practice of communicable disease control was compared between the two countries in three specific fields: seasonal influenza surveillance; human immunodeficiency virus (HIV) surveillance; and the childhood vaccination system. The organization structure for communicable disease control was very similar, comprising of government, national, regional and sub-regional tiers in Hungary, and government, national and local (sub-regional) tiers in Scotland. The influenza surveillance system in both countries was mainly based on the 'fluspotter system'. In the 2005/6, 2006/7 and 2007/8 seasons, there was no exceptional influenza activity in either country. Although the data collection and surveillance system of HIV is similar, there was a massive difference in the number of reported cases. In 2007, the cumulative incidence of reported HIV cases was 14.74/100,000 in Hungary and 105.21/100,000 in Scotland. The routine childhood vaccination schedule is similar in the two countries. However, while the vaccine uptake rates were nearly 100% in Hungary, these rates were lower in Scotland. The numbers of reported pertussis (98 vs 48), mumps (2741 vs 16), rubella (146 vs 0) and measles (168 vs zero) cases were significantly higher in Scotland than in Hungary. There were no differences for polio and chickenpox. The economic difference between the two countries not reflected in the efficiency of communicable disease control and in communicable disease patterns. The historical, political and cultural differences seem more determinative in this comparison.
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