[The tele-emergency physician system as a tool in preclinical emergency care: A stocktaking report on the quality of care based on selected characteristics]. / Das Telenotarzt-System als Instrument der präklinischen Notfallversorgung: eine aktuelle Bestandsaufnahme zur Versorgungsqualität anhand ausgewählter Merkmale.

INTRODUCTION: Due to the increasing proportion of older people in the German population, the age group-specific burden of disease is also rising, which consequently leads to an escalating need for emergency medical care in the preclinical sector. Within the German health care system, the growing shortage of physicians and the associated deficit of emergency physicians are further aggravating factors, which can lead to relevant gaps in care. METHODS: Through a systematic literature search for the period from January 1, 2000 to March 1, 2023 on prehospital telemedical emergency services (tele-EMS), selected quantitative and qualitative characteristics according to the PICOS scheme and the PRISMA statement were made available as examples; these were then used to critically categorize the quality of telemedically supported emergency care in Germany. RESULTS: The 23 selected publications comprised 17 clinical trials (including five quasi-experimental, ten observational, and two mixed-methods studies), four simulation studies, and two surveys. The incidence of technical problems ranged from 3% to 20% in the trials. Overall, the majority showed benefits in terms of faster availability of emergency medical expertise on scene together with a shortening of the treatment-free interval. The studies also indicated that patient registrations at the hospital providing further treatment took place at an earlier time. Furthermore, a reduction in the number and duration of emergency medical interventions was also evident. CONCLUSION: Currently, there still is a considerable need for optimization both with regard to the nationwide establishment of the tele-EMS and its design in already existing digital support systems. To be able to guarantee a customized continuity of care, a goal-oriented application and expansion of a digital infrastructure in the field of emergency medicine offers an option for guaranteeing up-to-date and qualitatively acceptable preclinical emergency care.

[Urine Screening for Narcotics under Court-Imposed Abstinence Requirements: Comparative Validity of Forensic-Toxicological Analyses with Involvement of Public Health Services]. / Urinscreenings auf Betäubungsmittel unter gerichtlichen Abstinenzauflagen ­ Vergleichsvalidität von forensischtoxikologischen Analysen unter Mitwirkung des Öffentlichen Gesundheitsdienstes.

AIM OF THE STUDY: Assessment of the comparative validity between qualitative and quantitative analyses of urine screenings for defined narcotics residues under court-imposed abstinence restrictions. METHODS: Following the introduction of a valid marker system which, based on the application of a defined sugar substance and its detection in the urine of person under probation in 2006, urine samples were assayed in administrative cooperation by a Bavarian public health office for probationary services for evidence of narcotics. The urine samples were sent to an external laboratory in order to carry out forensic toxicological analyses for defined narcotics. The qualitative and quantitative laboratory results were reported back to the public health department so that a digital-based data set of a total of 380 persons with more than 27,000 individual analyses from a total of 14 consecutive calendar years could be established and retrospectively evaluated in an anonymised form. RESULTS: The overall prevalences of findings positive for narcotics were 2.7% (n=366 of 13,531) for the qualitative and 2.6% (n=348 of 13,525) for the subsequent quantitative result categorisations, with cannabis and opiates being detected most frequently in both test methods. Using the kappa coefficient as a quantitative measure for the comparative validity of both test methods, the test results showed the highest agreement (1.000) for buprenorphine and lowest agreement for PCP (0.880). No age- and gender-specific stratifications could be recorded for a total of ten different narcotic substances; substance-specific case numbers differed among the analyses. CONCLUSION: Based on the strong to very strong correspondences between qualitative and quantitative narcotics analysis results, it could be assumed that both analysis methods accurately recorded violations of abstinence requirements and were to be classified as sufficiently substantiating for judicial decisions under the Narcotics Act (Betäubungsmittelgesetz, BtMG). According to these results, the content of urine screenings for narcotics controlling abstinence should be discussed.

[Narcotic Use under Probation and Parole Supervision - A longitudinal Study of Risk-group-specific Recidivism under Abstinence Conditions]. / Betäubungsmittelkonsum unter Bewährungs- und Führungsaufsicht ­ Eine Langzeituntersuchung zum risikogruppenspezifischen Rückfallgeschehen unter Abstinenzauflagen.

STUDY OBJECTIVE: The aim of this long-term study was to record substance-specific prevalences of illegal use of narcotics despite court-imposed abstinence requirements. METHODS: Urine assays were obtained by a public health department on the basis of administrative assistance for the probation department of a district court. The individual and valid allocation of these urine samples was ensured using a proven marker system. After postal dispatch, laboratory chemical analyses for narcotics residues were carried out in an external laboratory via enzyme immunoassay and validation by mass spectrography in the case of positive narcotics results. On the basis of all available routine data, a pooled data set covering a total of fourteen consecutive calendar years (2006-2019) was generated digitally and evaluated anonymously. RESULTS: From a total of 380 subjects (female: 13% versus male: 87%; average age: 30.4 years), 13,500 individual narcotic substance analyses from 2,941 urine samples were available. In 2.7% of all individual analyses, at least one of eight potential narcotic substances was detected, whereby the highest overall prevalences in the sense of a relapse were found for cannabis with 3.7% and for opiates with 2.4%. In contrast, there were almost no residues for barbiturates and LSD and no positive evidence for buprenorphine and PCP. As expected, most relapses in all narcotics groups were found in the age groups from 18 to 35 years. Strikingly, more women than men violated the court abstinence order with amphetamines, while relapses with the other seven narcotics groups occurred predominantly among men. In the course of the entire observation period, the most marked fluctuations in relapse rates were found for cannabis, opiates and cocaine. CONCLUSION: The use of narcotic substances during probation and parole supervision does not appear to be a rare occurrence and has received little professional attention. Increased attention to this group-specific recidivism and more studies on this topic should help reduce this deficit.

[Association Between Grounds for Legal Commitment to a Psychiatric Facility and Assessment of Fitness to Drive: An Orientating Analysis of the Relevance of Driving-Related Medicine to the National Health Service and Other Implicated Actors]. / Öffentlich-rechtliche Unterbringung und Fahreignung ­ Eine orientierende Untersuchung von verkehrsmedizinischer Relevanz für den Öffentlichen Gesundheitsdienst und andere Akteure.

AIM OF THE STUDY: The objective of this analysis was to record the social and epidemiological characteristics of a specific sample population, as well as to identify any associations between a previous commitment to a public facility on legal grounds and subsequent assessments of an individual's fitness to drive as per the National Health Service (or "ÖGD"). METHODS: For the retrospective data analysis, the documents of 87 subjects were evaluated who had been committed to public psychiatric institutions on legal grounds between 2015 and 2019. Using the SAS software package, frequency distributions and statistical relationships were identified between specific features of the commitment to accommodation and the assessment of fitness to drive by means of Chi-squared testing. RESULTS: The average age of the study cohort was 43.5 years (range: 16-82 years; male: 59%). The most frequent grounds for commitment to a facility were suicidal intentions expressed by the person in question. In one third of the cases, these individuals were under the influence of alcohol at the time of commitment to the facility, and drug use was documented in 3 of the 87 cases. In 74% of cases, confinement was solely due to an individual's risk to themselves; in 26% a risk to others was (additionally) identified; and in 20% of those affected, there was verbal and/or physical resistance to commitment to the accommodation facility. In 57% of cases, the medical evaluation raised doubts about the individual's fitness to drive, resulting in the matter being referred on to the driving license authority. Statistically significant associations were demonstrated between: a) the grounds for commitment to a facility; the type of risk; and resistance to commitment being enforced, and b) the results of a fitness-to-drive assessment carried out by the ÖGD. CONCLUSION: The data available on individuals committed to public facilities on legal grounds in connection with driving-related medical issues should be optimised to improve quality, whereby the anonymous registration system, introduced on the basis of the Bavarian Mental Health Act ("BayPsychoKHG"), can make a contribution in this regard. In addition, further qualification measures for effective quality management are necessary for all actors involved.

[Preventive Check-ups and Routine Vaccinations in Pre-school Children - An Analysis of Mutual Participation Behaviour, Taking into Account Living Conditions]. / Vorsorgeuntersuchungen und Routineimpfungen bei Vorschulkindern ­ Eine Analyse zum wechselseitigen Teilnahmeverhalten unter Einbeziehung der Lebensverhältnisse.

AIM OF THE STUDY: Preventive screenings and vaccinations are essential health protecting measures in childhood, but no quantitative data on mutual distribution patterns of acceptance are available. The aim of the study was the quantification of distribution patterns and the identification of associations between preventive check-ups and defined routine vaccinations for children starting school, taking into account the social environment. METHODS: The 2015 school entrance health checks included documented preventive screenings and routine vaccinations on a city-wide basis. In addition, a voluntary proxy questionnaire was distributed to persons entitled to care for the children starting school in order to record additional characteristics of family living conditions. We used SPSS 25.0 to calculate participation rates for all screenings and defined routine vaccinations as well as specific cross-prevalences and associations. RESULTS: Of the 407 children starting school, both prevention measures were carried out in 76.8%; additional questionnaires were distributed to those in charge of 280 (68.8%) of these children. Full preventive check-ups with complete vaccination status at the same time were observed in 70.3% of children born in Germany and 69.7% of children born in Germany with German nationality. In terms of family environment, children with siblings (17.5%), children with separated parents (13.3%) and families with up to four close relatives (7.1%) were significantly less likely than others to have completed all preventive measures. Incomplete preventive medical examinations were strongly associated with a child not born in Germany (OR=7.95) and with both parents with a non-German Nationality (OR=4.52). CONCLUSION: The distribution patterns and associations identified provide new insight for the establishment of measures specific to risk groups to increase acceptance of screenings and defined routine vaccinations. This can allow for needs-optimised health care for children based on the principle of social compensation.

[The Asian Tiger Mosquito (Aedes albopictus) as a Challenge for the Public Health Service: An Example of a Risk Management Strategy Adapted to the Situation at the Local Level]. / Die Asiatische Tigermücke (Aedes albopictus) als Herausforderung für den Öffentlichen Gesundheitsdienst ­ Exemplarische Darstellung eines situationsadaptierten Risikomanagements auf lokaler Ebene.

AIM OF THE STUDY: Case report on risk management for the epidemiology of an infectious disease threat scenario at the municipal level using the example of the Asian tiger mosquito (ATM) with communication of figures based on experience to stakeholders in the public health service METHODS: Formal and substantive presentation of a list of defined control measures together with site-specific modification and evaluation of efficacy RESULTS: Based on a timely education campaign, establishment of a population of ATM first observed in the fall of 2016 could be prevented at the local level. With favourable low temperatures during the 2016/2017 winter months, primarily physical control methods were effective. In the spring of 2017, ATM was no longer detected by a total of 4 monitoring units, each with a suction trap and 3 passive traps. In the following period, up to and including the spring of 2019, no invasive species of mosquito were identified in the cemetery originally involved or in the adjacent residential areas or recreational grounds Overall, cooperation among external experts and stakeholders from the public health service at the level of individualised medicine were able to prevent an insect-borne infection of the local population; a gradual approach following defined criteria for insect control proved to be effective and efficient. CONCLUSION: The occurrence of the ATM is primarily a local event that requires a differentiated weighing-up between a specific and abstract hazard potential by the regional health authorities. In addition to an objective and prompt education campaign for the population involved as a trust-building action, primary physical control measures in terms of barrier measures are effective; if necessary, chemical and biological controls can be used as complementary measures.

Socio-economic, infrastructural and health-related risk factors associated with adverse heat-health effects reportedly experienced during hot weather in South Africa.

INTRODUCTION: Poor urban communities are likely to bear the brunt of climate change impacts on health and well-being. The City of Johannesburg, South Africa, is predicted to experience an average increase in ambient temperature of 4°C by 2100. Focusing on the urban environment, this study aimed to determine socio-economic, infrastructural and health-related risk factors for heat-related adverse health effects. METHODS: This was a cross-sectional study. Data of interest were collected using a pretested and validated questionnaire administered to parents of children attending schools participating in a school heat study. Information related to demographic, socio-economic and household-level determinants of health, which has an impact on the individual prevalence of adverse heat-health effects associated with hot weather, was collected for 136 households and 580 individuals. RESULTS: Sweating (n = 208 individuals; 35%), headache and nausea (n = 111; 19%) and weakness, fatigue and dizziness (n = 87; 15%) were the most common heat-health effects reportedly experienced by individuals (n = 580) during hot weather. Individuals who suffered from hypertension (OR = 2.32, 95% CI: 1.34 - 4.05, p = 0.003) and individuals older than 60 years (OR = 1.81, 95% CI: 1.27-1.99, p < 0.001) compared to other age groups were more likely to experience 'any heat-health effects'. Living in government-sponsored detached housing and in houses with asbestos roofs were associated with an increase in reported experience of 'any heat-health effects' compared to living in other housing types. CONCLUSION: Heat-health awareness campaigns should target people suffering from pre-existing diseases and the elderly, as these groups are especially vulnerable to heat. Focus should also be given to appropriate roofing and insulation in government-sponsored housing since summertime temperatures are projected to increase.

[Competing Validity of Developmental Diagnostic in School Entry Examination: Results of a Census in an Upper Bavarian District]. / Konkurrierende Validität der Entwicklungsdiagnostik zum Zeitpunkt der Schuleingangsuntersuchung ­ Ergebnisse einer Vollerhebung in einem oberbayerischen Landkreis.

AIM OF THE STUDY: Evaluation of the concurrent validity of a modified Bavarian model (BM) compared to the social-paediatric screening of developmental status for school entry (SOPESS) as a reference tool. METHODS: A total of 407 preschoolers to be enrolled for the school year 2015 in an Upper Bavarian District were examined by BM and SOPESS. As a measure of the concurrent validity, the Kappa by Cohen (ĸ) was used. RESULTS: The agreement of both instruments was moderate and was less pronounced for single dimensions than globally. The agreement in the dimensions of "prepositions" vs. "grammatism" (ĸ=0.46) was highest and for the dimensions "numbers and quantities" vs. "calculus" (ĸ=0.05). Stratification by age, gender, nationality and mode of the study programs had no significant influence on the strength of the effects. CONCLUSION: The moderate agreement between the 2 instruments raises the question of the validity of BM used so far in school enrollment examinations.

Time trends and determinants of multiple development delays in Bavarian preschool children: a retrospective analysis from 1997 to 2010.

OBJECTIVES: The aim of this study was to identify the time trends of multiple developmental delays and to determine the strength of selected factors influencing preschool child's development. METHODS: We reviewed the records of 13,876 preschoolers in a district of Lower Bavaria to determine prevalence and time trends of combined developmental delays from 1997 to 2010. The effect of age, sex and nationality on development was estimated by using regression models. RESULTS: The largest increase was in the area of psychosocial development (1997:3.8 % versus 2010:13.8 %), followed by twofold combined delays in motor (2.6 versus 14.4 % in 2009) and twofold delays (1.3 versus 6.2 %) in cognition. Youngest children (4.26-5.49 years) had the highest risk for twofold delays in motor (4.78; 95 % CI 3.30-6.92), whereas strongest protection was observed for girls (0.28; 95 % CI 0.22-0.36) for threefold delays in motor and for a German nationality (0.30; 95 % CI 0.20-0.43) for fourfold delays in cognition. CONCLUSIONS: According to this study, multiple disabilities in development were increasing in preschool children. These children can be considered as a risk group who therefore require measures in Public Health.

Influence of kindergarten on numbers of multiple developmental delays in preschoolers: an analysis over 14 years.

OBJECTIVES: The aim of the study was to calculate the impact that the duration of attendance and the location of the kindergarten (rural versus urban) has on the prevalence of multiple delays in preschool children. METHODS: We analyzed data from 14,068 preschool children, over a period of 14 consecutive years (1997-2010) from the Bavarian Pre-School Morbidity Survey using software package SPSS 21.0. We assessed the incidence of multiple developmental impairments (twofold or above) in various developmental domains. RESULTS: The highest prevalence for multiple delays in development existed for twofold impairments in the area of motor (7.9 %) and lowest in fivefold delays in cognition (0.4 %). A shorter duration of visiting a kindergarten (OR: 4.43) and an urban location (OR: 2.53) was associated with an increased risk of multiple delays in development. CONCLUSIONS: A shorter duration and an urban location of kindergarten attendance are associated with an increased risk for children having multiple developmental impairments. From a public health perspective, the setting and duration of kindergarten attendance may be an important focus in preventive efforts to optimize health outcomes in children.

[Exercise scenario of a highly contagious, life-threatening disease in intercontinental aviation : a case report in the context of the International Health Regulations (IHR)]. / Übungsszenario für eine hochkontagiöse, lebensbedrohliche Erkrankung in der interkontinentalen Personenluftfahrt : Eine Kasuistik vor dem Hintergrund der internationalen Gesundheitsvorschriften (IGV).

BACKGROUND: The International Health Regulations (IHR) 2005 were conformed to German law on July 20, 2007 and described in detail by the Implementing Act (IHR DG). According to these legal bases, "designated airports" must maintain special capacities for protection against health threats, and are also responsible for performing regular IHR exercises. OBJECTIVES: Representation of the optimization of established operational concepts of various professions to manage infectious biological threats without obstruction of international travel, and mediation of experience to IHR professionals. MATERIALS AND METHODS: An exercise based on the case scenario of a travel-related febrile illness was performed at Munich International Airport on November 11, 2013. Preparations took 6 months and the exercise itself lasted nearly 12 h. The follow-up lasted an additional 9 months. A qualitative and quantitative evaluation of the exercise was completed. RESULTS: From an Individual Medicine and Public Health perspective, modular work structures and risk communication functioned adequately. The medical examination of passengers was also well managed. Areas requiring further optimization included arrival/departure times of external actors, transport of the index patient to hospital and protective measures for individual participants. Overall, a defined biological threat scenario representing a double infection with two highly pathogenic germs was handled satisfactorily without affecting international air travel. CONCLUSIONS: Modular supply components are an effective and forward-looking means in protection against threats occurring at airports. Key success factors include sufficient staff mobility, immediate self-protection of actors involved, effective risk communication and a strong overall coordination and monitoring of the situation.

Clustering of developmental delays in Bavarian preschool children - a repeated cross-sectional survey over a period of 12 years.

BACKGROUND: While most children display a normal development, some children experience developmental delays compared to age specific development milestones assessed during school entry examination. Data exist on prevalence of delays in single areas, but there is lack of knowledge regarding the clustering patterns of developmental delays and their determinants. METHODS: During the observation period 1997-2008, 12 399 preschool children (5-7 years of age) in one district of Bavaria, Germany, were assessed in twelve schooling-relevant development areas. The co-occurrence of developmental delays was studied by means of Pearson's correlation. Subsequently, a two-step cluster algorithm was applied to identify patterns of developmental delays, and multinomial logistic regression was conducted to identify variables associated with the specific patterns. RESULTS: Fourteen percent of preschool children displayed developmental delays in one and 19% in two or more of the studied areas. Among those with at least two developmental delays, most common was the combination of delays in "fine motor skills" + "grapho-motor coordination" (in 9.1% of all children), followed by "memory/concentration" + "endurance" (5.8%) and "abstraction" + "visual perception" (2.1%). In the cluster analysis, five distinct patterns of delays were identified, which displayed different associations with male gender and younger age. CONCLUSIONS: While developmental delays can affect single areas, clustering of multiple developmental delays is common. Such clustering should be taken into account when developing diagnostic tests, in pediatric practice and considering interventions to reduce delays.

Outbreak-related mumps vaccine effectiveness among a cohort of children and of young adults in Germany 2011.

Mumps outbreaks in populations with high 2-dose vaccination coverage and among young adults are increasingly reported. However, data on the duration of vaccine-induced protection conferred by mumps vaccines are scarce. As part of a supra-regional outbreak in Germany 2010/11, we conducted two retrospective cohort studies in a primary school and among adult ice hockey teams to determine mumps vaccine effectiveness (VE). Via questionnaires we collected information on demography, clinical manifestations, and reviewed vaccination cards. We estimated VE as 1-RR, RR being the rate ratio of disease among two-times or one-time mumps-vaccinated compared with unvaccinated persons. The response rate was 92.6% (100/108--children cohort) and 91.7% (44/48--adult cohort). Fourteen cases were identified in the children and 6 in the adult cohort. In the children cohort (mean age: 9 y), 2-dose VE was 91.9% (95% CI 81.0-96.5%). In the adult cohort (mean age: 26 y), no cases occurred among the 13 2-times vaccinated, while 1-dose VE was 50.0% (95% CI -9.4-87.1%). Average time since last vaccination showed no significant difference for cases and non-cases, but cases were younger at age of last mumps vaccination (children cohort: 2 vs. 3 y, P=0.04; adult cohort: 1 vs. 4 y, P=0.03). We did not observe signs of waning immunity in the children cohort. Due to the small sample size VE in the adult cohort should be interpreted with caution. Given the estimated VE, very high 2-dose vaccination coverage is required to prevent future outbreaks. Intervention efforts to increase coverage must especially target young adults who received<2 vaccinations during childhood.

Individual development of preschool children-prevalences and determinants of delays in Germany: a cross-sectional study in Southern Bavaria.

BACKGROUND: Even minor abnormalities of early child development may have dramatic long term consequences. Accurate prevalence rates for a range of developmental impairments have been difficult to establish. Since related studies have used different methodological approaches, direct comparisons of the prevalence of developmental delays are difficult. The understanding of the key factors affecting child development, especially in preschool aged children remains limited. We used data from school entry examinations in Bavaria to measure the prevalence of developmental impairments in pre-school children beginning primary school in 1997-2009. METHODS: The developmental impairments of all school beginners in the district of Dingolfing-Landau, Bavaria were assessed using modified "Bavarian School Entry Model" examination from 1997 to 2009 (N=13,182). The children were assessed for motor, cognitive, language and psychosocial impairments using a standardised medical protocol. Prevalence rates of impairments in twelve domains of development were estimated. Using uni- and multivariable logistic regression models, association between selected factors and development delays were assessed. RESULTS: The highest prevalence existed for impairments of pronunciation (13.8%) followed by fine motor impairments (12.2%), and impairments of memory and concentration (11.3%) and the lowest for impairments of rhythm of speech (3.1%). Younger children displayed more developmental delays. Male gender was strongly associated with all developmental impairments (highest risk for fine motor impairments = OR 3.22, 95% confidence interval 2.86-3.63). Preschool children with siblings (vs. children without any siblings) were at higher risk of having impairments in pronunciation (OR 1.31, 1.14-1.50). The influence of the non-German nationality was strong, with a maximum risk increase for the subareas of grammar and psychosocial development. Although children with non-German nationality had a reduced risk of disorders for the rhythm of speech and pronunciation, in all other 10 subareas their risk was increased. CONCLUSIONS: In preschool children, most common were delays of pronunciation, memory and concentration. Age effects suggest that delays can spontaneously resolve, but providing support at school entry might be helpful. Boys and migrant children appear at high risk of developmental problems, which may warrant tailored intervention strategies.

Kindergarten attendance may reduce developmental impairments in children: results from the Bavarian Pre-School Morbidity Survey.

BACKGROUND: The relative risks and benefits of children attending kindergarten or pre-school remain uncertain and controversial. We used data from the Bavarian Pre-School Morbidity Survey (BPMS) to look at the prevalence of developmental impairments in pre-school children entering primary school and to assess if these were correlated with the duration of kindergarten attendance. METHODS: We collected data from all school beginners in the district of Dingolfing, Bavaria from 2004 to 2007 (n = 4,005) and utilised a retrospective cross-sectional study design to review the information. The children were assessed for motor, cognitive, language and psychosocial impairments using a standardized medical assessment. Point prevalence of impairments of speech, cognition, motor functioning and psychosocial functioning were compared by chi(2)-test for the variable of time spent in kindergarten. RESULTS: We detected a high incidence of impairments, with boys showing higher rates than girls in all the areas assessed. Longer length of time spent in kindergarten was associated with reduced rates of motor, cognitive and psychosocial impairments. There was no clear correlation between length of kindergarten attendance and speech disorders. CONCLUSIONS: Kindergarten attendance may have a positive effect on a number of domains of development including motor, cognitive and psychosocial development, but no significant effect on speech impairments. Implications for public health policies are discussed.

Association between acculturation and childhood vaccination coverage in migrant populations: a population based study from a rural region in Bavaria, Germany.

OBJECTIVES: The aim of our analysis was to investigate the association between acculturation and the vaccination coverage among pre-school children. METHODS: We performed a study of vaccination status for measles-mumps-rubella and hepatitis B among pre-school children, during mandatory school entry examinations, in a district of Bavaria, Germany, in 2004 and 2005 (N = 2,043). Prior to the examinations, parents were asked to fill out a self-administered questionnaire assessing socio-demographic information, including variables related to migration background (response rate 73%, N = 1,481). We used Categorical Principal Component Analysis (CATPCA) to create an acculturation index and assessed the association between the acculturation and vaccination status for both vaccines. RESULTS: We found no difference in vaccination status with the measles-mumps-rubella vaccine in relation to acculturation. The coverage with at least three doses of hepatitis B vaccine was similar among migrants and in the indigenous population, but the risk of incomplete (1 or 2 doses) versus full vaccination was higher (OR = 2.74, 95% CI 1.34-5.61) and the risk of lacking vaccination lower (OR = 0.30, 95% CI 0.12-0.77) among less acculturated migrants compared to the indigenous population. CONCLUSIONS: For multi-dose vaccines lower acculturation was associated with incomplete vaccination, but the partial protection in this group was higher compared to indigenous population.