A modeling exercise comparing the impact of different vaccination strategies at the population level is currently being carried out for Germany and will inform STIKO decision-making in addition to other data such as the results derived from the present survey. We express our sincere thanks to the 15 pediatricians that pretested the questionnaire, all participating physicians and the German Professional Association for Pediatricians (BVKJ) for their support of the survey. Furthermore, we thank all colleagues in the Immunization Unit at the Robert Koch Institute for help with the survey logistics, especially Sarah Wetzel, Hydroxychloroquine manufacturer Gabi Metzner-Zülsdorf, Kerstin Dehmel and Willi Koch, and Kristin

Tolksdorf for her statistical advice. The study was funded by the Robert Koch Institute. Conflict of interest None of the authors report potential conflicts of interest. “
“Influenza is an important cause of morbidity and mortality globally, resulting in an estimated

3–5 million cases of severe influenza illness and 250,000–500,000 annual deaths worldwide [1]. The annual attack rate with influenza viruses is 5–10% in adults and 20–30% in children [2]. Groups at particular GDC-0199 research buy risk of severe influenza infections include pregnant women, children aged <5 years, the elderly (≥65 years), and individuals with underlying non-communicable health conditions such as heart disease, asthma and diabetes. Most influenza deaths occur in adults over 65 years of age. Vaccination is currently the most effective means of preventing influenza infection. Currently licensed influenza vaccines are safe and efficacious GPX6 and prevent significant annual morbidity and mortality [2]. Recommended target populations for influenza vaccination programs include pregnant women, children aged 6–59 months, the elderly,

individuals with specific chronic non-communicable diseases, and health-care workers [2]. In 2003, a World Health Assembly (WHA) resolution set a target calling for an increase in influenza vaccine coverage rates (VCR) for all people at high risk and at least 50% of the elderly by 2006, and 75% by 2010 [3]. Since then, the Council of the European Union has recommended that member states achieve VCR of 75% in the elderly and other risk groups and improve the vaccination coverage in health care workers by the 2014–2015 influenza season [4]. With clear national and supranational recommendations for vaccination, countries would be expected to achieve the recommended 75% vaccination coverage target. Yet influenza vaccination coverage remains below recommended levels in many countries. In Europe, influenza vaccination is recommended for about 36% of the population or approximately 180 million persons. Yet only about 80 million persons (44% of the population for whom vaccination is recommended) are estimated to receive vaccine annually [5]. In the US, influenza vaccination coverage in all age groups combined was 41.8% in 2011–2012 [6].