There has been an increase in reported TBE cases in Europe since 2015, reaching a peak in some countries in 2020, highlighting the need for better management of TBE risk in Europe. TBE surveillance is currently limited, in part, due to varying diagnostic guidelines, access to testing, and awareness of TBE. Consequently, TBE prevalence is underestimated and vaccination recommendations inadequate. TBE vaccine uptake is unsatisfactory in many TBE-endemic European countries. This review summarizes the findings of a scientific workshop of experts to improve TBE surveillance and vaccine uptake in Europe. Strategies to improve TBE surveillance and vaccine uptake should focus on: aligning diagnostic criteria and testing across Europe; expanding current vaccine recommendations and reducing their complexity; and increasing public education of the potential risks posed by TBEV infection.

Background: Pneumococcal conjugate vaccines (PCVs) have proven effective in preventing both non-invasive and invasive pneumococcal disease (IPD) in small children and in older age groups. However, long-term observations and country comparisons of IPD incidence in the elderly following introduction of PCVs in paediatric national immunisation programmes (NIPs) are scarce. We aimed to estimate and compare incidence of IPD in the elderly in Denmark, Finland, Norway, and Sweden over a 10-year time span. During the study period Denmark and Norway used PCV13 in their paediatric NIP, Sweden both PCV10 and PCV13 and Finland used PCV10. Uptake of pneumococcal vaccines for the elderly was low. Method: We collected longitudinal data on confirmed IPD cases and their serotypes among elderly people (aged ≥65 years) 2010–2019 in the four countries of interest. Annual IPD incidence rates were calculated per country, by vaccine-associated serotypes (PCV10, PCV13, PCV15, PCV20 and PPV23) and for non-vaccine serotypes. A regression model was used to estimate average annual change in incidence in each country. Results: Incidence rates of IPD in the elderly in 2019 ranged from 31.4 to 41.8 per 100,000 people across the countries. Denmark and Norway showed an annual average decline in IPD incidence (-3.3; 95% CI: -5.6 to -1.1; p<0.01) and (-3.3; 95% CI: -5.5 to -1.0; p<0.01) respectively from 2010 to 2019, whereas no change was seen for Sweden (-0.5; 95% CI: -1.9 to 0.8; p = 0.39) or Finland (0.9; 95% CI: -1.0 to 2.7; p = 0.32). IPD incidence due to emerging serotypes, e.g., serotypes 8 and 12F, has increased. Serotype 19A remained a major cause of IPD in countries with PCV10 in paediatric NIPs. Conclusion: Despite paediatric PCV programmes, a considerable vaccine preventable IPD burden remains in the elderly. Further, choice of PCV in paediatric programs was associated with differences in serotype distribution and incidence amongst the elderly. Direct vaccination of the elderly with recently approved broad coverage PCVs holds promise for meaningful impact on disease burden with PCV20 covering a majority of IPD amongst the elderly in the four studied countries. Effectiveness of new vaccines in real-life clinical practice should be followed.

Tick-borne encephalitis (TBE) vaccines are highly effective in preventing TBE and vaccine failures (VF) are rare events. In this study, we compared the age distribution of TBE cases and TBE VF in three endemic countries: Sweden, Southern Germany, and Latvia. While the age distribution of TBE cases was similar for those <50 years versus those ≥50 years in all three countries, in Sweden, a higher proportion of VF cases was ≥50 years, whereas most VF cases in Latvia were <50 years of age and more evenly distributed between those <50 years versus those ≥50 in Southern Germany. Here, theoretical explanations were provided, including differences in diagnostic practices, vaccine uptake between age groups, behavioral patterns and underlying medical conditions, as to why VF were generally older in Sweden than the other countries. There is no scientific rationale to give an extra priming dose of TBE vaccine to subjects ≥50 years of age.

Introduction: The aim of this study was to investigate the seroprevalence of IgG antibodies to Borrelia burgdorferi sensu lato (Bbsl) in the Swedish population, an indication of ongoing or previous Bbsl infection, by assessing seroprevalence among healthy blood donors covering all administrative regions.Methods: Sera from 2058 healthy adult blood donors were collected during 2024 in Sweden’s 21 administrative regions. Anti-Bbsl IgG antibodies were detected in sera using Liaison Borrelia IgG VlsE kit as a screening test and Anti-Borrelia EUROLINE-RN-AT IgG as a confirmatory test.Results: The analyses revealed an overall seroprevalence of 16% with significant differences between age groups, sexes and geographical regions. The seroprevalence in females was 11% compared to 21% in males (p<0.0001). Seroprevalence increased with age, from 8% in the youngest age group (18-29 years) to 29% in the oldest age group (60 years and above) (p<0.0001). The seroprevalence was higher in the southern and central parts of the country (17-19%), compared to the northern part (5%) (p<0.001). Among the 21 Swedish administrative regions, the seroprevalence ranged from 0% in Region Norrbotten to 27% in Region Gotland. Conclusions: Except for the Northern part of Sweden, the seroprevalence of antibodies to Bbsl indicates that a substantial proportion of the population has been infected with Bbsl. The seroprevalence varies with sex and across different age groups, which should be taken into consideration in the interpretation of serological test results for the diagnosis of LB. Furthermore, the outcomes of the study indicate that the LB disease burden may be substantial in Sweden.