Tick-Borne Encephalitis (TBE) Vaccine in the National Immunisation Programme-For Whom, When and Where?

The incidence of Tick-borne encephalitis (TBE) cases has increased. The presumed location of transmission of Tick-borne encephalitis virus (TBEV) has been expanding increasingly in the western parts of Europe during the past decade. There has also been an increased incidence of surveillance-reported TBE cases in southern Sweden and southern Norway. Additionally, the warmer climate has enabled ticks to be present to a greater extent in the northern part of Scandinavia. In several reports, pre-school children tend to have a lower TBE incidence rate compared to teenagers, whereas both younger children and teenagers may experience severe neurological symptoms such as meningitis and encephalitis. In addition to physical impairments, long-term cognitive and mental impairments have been observed in up to 70% of children with TBEV infection. These may include attention deficits, reduced concentration and impaired memory, which can significantly affect daily life and school performance. Finland, Latvia and Slovenia have already included TBE vaccines in their National Immunisation Program (NIP). TBE vaccines are safe and effective for children from the age of 1, and we propose all countries with endemic areas include TBE vaccines in their future NIP. This is a cost-effective strategy and, even more important, a pivotal equity strategy for all European children.