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The first pneumococcal vaccine targeting the youngest age groups, a seven-valent conjugate vaccine (PCV7), was licensed in Europe in 2001. Since then several European countries have introduced PCV7 in their childhood vaccination schedules. Still, information on vaccination schemes, vaccine uptake and impact of vaccine introduction is scarce in Europe. The following article summarises the characteristics of national pneumococcal vaccination programmes for children in 32 European countries and provides an estimate of vaccine use based on sales data for 22 countries between 2001 and 2007. There were wide variations in the recommended PCV7 vaccination schemes and in PCV7 use. High vaccine uptake was not always related to the presence of a national vaccination programme.

In order to estimate the incidence of invasive pneumococcal diseases (IPD) and the amount of vaccine preventable serious infections, a 1-year population-based surveillance was undertaken in two comparable Italian regions (Piemonte and Puglia, representing 14% of the Italian population) prospectively collecting data and strains from all the hospital microbiological laboratories. A retrospective analysis of hospital discharge records, matched with the laboratory database, was also undertaken in nine hospitals in these two regions to determine the frequency of use of blood cultures and its impact on IPD incidence estimate. For children under 2 years of age, the incidence rates of IPD were 11.3 per 100,000 and 5.9 per 100,000 in Piemonte and in Puglia, respectively; for subjects 65 years of age and over the incidence rates were 5.7 per 100,000 and 0.2 per 100,000, in the two regions, respectively. The number of blood cultures performed was six times higher in Piemonte than that in Puglia. About 96% of isolates from IPD patients, aged 65 years and over, belonged to serogroups included in the 23-valent polysaccharide vaccine, whereas about 79% of strains isolated from patients under 5 years of age were related to serotypes included in the 7-valent conjugate vaccine. The estimate of the incidence of IPD is affected greatly by the different attitudes in performing blood cultures, especially in older patients. In Italy, bacteriological culture procedures should be undertaken more frequently to provide decision-makers with reliable estimates of serious vaccine preventable conditions.

Measles is a highly contagious and potentially fatal disease. Europe is far from the 95% coverage rates necessary for elimination of the disease, although a safe and cost-effective vaccine is available. We reviewed the literature on studies carried out in European countries from January 1991 to September 2011 on knowledge, attitudes and practices of health professionals towards measles vaccination and on how health professionals have an impact on parental vaccination choices. Both quantitative and qualitative studies were considered: a total of 28 eligible articles were retrieved. Healthcare workers are considered by parents as a primary and trustworthy source of information on childhood vaccination. Gaps in knowledge and poor communication from healthcare workers are detrimental to high immunisation rates. Correct and transparent information for parents plays a key role in parental decisions on whether to have their children vaccinated. Healthcare workers' knowledge of and positive attitudes towards measles-mumps-rubella (MMR) vaccination are crucial to meeting the measles elimination goal. An effort should be made to overcome potential communication barriers and to strengthen vaccine education among healthcare professionals.

This report provides an updated overview of recommended and mandatory vaccinations in the European Union (EU), Iceland and Norway, considering the differences in vaccine programme implementation between countries. In 2010, the Vaccine European New Integrated Collaboration Effort (VENICE) network, conducted a survey among the VENICE project gatekeepers to learn more about how national vaccination programmes are implemented, whether recommended or mandatory. Information was collected from all 27 EU Member States, Iceland and Norway. In total 15 countries do not have any mandatory vaccinations; the remaining 14 have at least one mandatory vaccination included in their programme. Vaccination against polio is mandatory for both children and adults in 12 countries; diphtheria and tetanus vaccination in 11 countries and hepatitis B vaccination in 10 countries. For eight of the 15 vaccines considered, some countries have a mixed strategy of recommended and mandatory vaccinations. Mandatory vaccination may be considered as a way of improving compliance to vaccination programmes. However, compliance with many programmes in Europe is high, using only recommendations. More information about the diversity in vaccine offer at European level may help countries to adapt vaccination strategies based on the experience of other countries. However, any proposal on vaccine strategies should be developed taking into consideration the local context habits.

Background: The Apulia region (Southern Italy) may be considered a “border region” which, due to its position, has to face daily arrivals of refugees, especially from Albania. When the exodus of Albanians took place in 1991, a seroepidemiologic study revealed a low seroimmunity to poliomyelitis. In 1996, a large outbreak of paralytic poliomyelitis occurred in Albania. The aim of the study was to evaluate the poliomyelitis immunization level in a sample of Albanian refugees who arrived in the Apulia region between April and May 1997. Methods: Blood samples were obtained, after informed consent and on a voluntary basis, from 667 subjects housed in seven refugee camps in the Apulia region. Titration of neutralizing antibodies to the three polioviruses was carried out. Results: The findings showed that Albanian refugees had adequate levels of immunity to all polioviruses (95%for poliovirus type 1, 98.6%for poliovirus type 2 and 91.4%for poliovirus type 3). Moreover, a high immunization rate was found in all age groups irrespective of the areas of origin of the refugees and their socioeconomic conditions. Conclusions: Our findings show that Albanian refugees in Apulia region have adequate levels of immunity against polioviruses and confirm the effectiveness of mass vaccination campaigns with OPV conducted by WHO in Albania following an outbreak of poliomyelitis in 1996.

Vaccination is an extremely effective tool in reducing the burden of infectious diseases. There are many vaccine products currently available in Europe. Vaccines developed recently have been introduced according to common European Union (EU)-wide regulatory procedures since 2003, which implies that they are licensed for common indications and population groups across the EU.