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Heterogeneity in vaccination coverage explains the size and occurrence of measles epidemics in German surveillance data

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Publication date 2011
Author Herzog Sereina, Paul Michaela, Held Leonhard,
Project Multivariate analysis of dependent count data
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Original article (peer-reviewed)

Journal Epidemiology and Infection
Volume (Issue) 139(4)
Page(s) 505 - 515
Title of proceedings Epidemiology and Infection


The objective of this study was to characterize empirically the association between vaccination coverage and the size and occurrence of measles epidemics in Germany. In order to achieve this we analysed data routinely collected by the Robert Koch Institute, which comprise the weekly number of reported measles cases at all ages as well as estimates of vaccination coverage at the average age of entry into the school system. Coverage levels within each federal state of Germany are incorporated into a multivariate time-series model for infectious disease counts, which captures occasional outbreaks by means of an autoregressive component. The observed incidence pattern of measles for all ages is best described by using the log proportion of unvaccinated school starters in the autoregressive component of the model.