Böhm et al. Tick-borne encephalitis vaccination in persons with a recent history of Lyme borreliosis: Insights from a knowledge, attitudes and behaviour survey in Bavaria, Germany. Ticks Tick Borne Dis. 2025;16:102445. doi:10.1016/j.ttbdis.2025.102445
In Germany, tick-borne encephalitis (TBE) vaccination rates remain low, even in high-risk regions—only about 20%–25% of adults and 32% of individuals under 18 years are vaccinated. Notably, approximately 97% of TBE cases occur in unvaccinated individuals.
A recent study conducted in Bavaria, a known TBE risk area, investigated the reasons for and barriers against TBE vaccination among individuals who had recently been diagnosed with Lyme borreliosis. Among the 366 participants, 249 (68%) reported that they were not vaccinated against TBE.
The most commonly cited reasons for receiving the TBE vaccine were “living in a risk area” (67.1%), “spending leisure time in tick-prone areas” (53.8%), and “physician’s recommendation” (46.6%). Conversely, the main barriers to vaccination included “skepticism about vaccines” (35.9%), “fear of vaccine side effects” (28.2%), “never thought about it” (19.7%), and perceiving a “low risk of contracting TBE” (17.9%).
Older age and greater knowledge about tick-borne diseases were positively associated with being vaccinated. The findings suggest that increasing awareness of the risk and likelihood of tick bites and TBE could lead to higher vaccination rates.
The authors concluded that raising public awareness about TBE risk areas and addressing misconceptions about vaccine safety are essential. Public health campaigns targeting high-risk groups and promoting vaccination recommendations are critical strategies to improve TBE vaccine uptake.