• Marlen Kofahl, Karla Romero Starke, Wiebke Hellenbrand, Alice Freiberg, Melanie Schubert, Stefanie Schmauder, Mascha Luisa Groß, Janice Hegewald, Daniel Kämpf, Johanna Stranzinger, Albert Nienhaus, and Andreas Seidler.
• Institute and Polyclinic for Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden; Immunization Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin; Institution for Statutory Social Accident Insurance and Prevention in the Health Care and Welfare Services (BGW), Basic Principles of Prevention and Rehabilitation, Section Occupational Health, Hamburg, Germany; Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Center Hamburg-Eppendorf (UKE), Hamburg.
• Dtsch Arztebl Int. 2020 May 22; 117 (21): 365372365-372.

BackgroundAdequate immunity to so-called childhood diseases can lower the occupational risk of vaccine-preventable infectious diseases in persons who work in day-care centers for children.MethodsA systematic literature survey was carried out in PubMed and Embase for the period January 2000 to February 2019. Studies on immune status and vaccination status were included. In addition, data from the first wave of the German Health Interview and Examination Survey for Adults (Studie zur Gesundheit Erwachsener in Deutschland, DEGS1) and surveillance data on notifiable infections in Germany were evaluated.ResultsSix studies and the DEGS1 analysis of vaccination or immune status for varicella zoster, rubella, hepatitis A (HAV), pertussis, measles, and mumps in persons caring for children in day-care centers, most of whom are women, were included in this review. According to DEGS1, childcare workers are more commonly vaccinated against HAV and pertussis than the general female population (prevalence ratios [PR]: 1.46 [1.12; 1.90] and 1.57 [1.05; 2.36]), yet 57% had not been vaccinated against HAV and 77% had not been vaccinated against pertussis. Childcare workers were found to be less commonly vaccinated against rubella than the general female population, although the difference was not statistically significant (PR: 0.87 [0.71; 1.07]). In a Canadian study, positive HAV serology was found to be correlated with the duration of activity as a childcare worker. In the DEGS1 study, large proportions of the younger childcare workers in particular were seronegative against measles (16%), mumps (19%), and HAV (37%). Notifiable disease statistics show that those working in community facilities had a markedly higher risk of mumps, pertussis, and varicella (relative risk [RR]: 1.8-2.6) and a somewhat higher risk of rubella and HAV (RR: 1.47 and 1.21, respectively).ConclusionChildcare workers have a higher occupational risk of infection but do not always receive the appropriate vaccinations. In particular, women of child-bearing age working in day-care centers should be made more aware of the need for vaccination.

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