Breakthrough Tick-Borne Encephalitis and Epidemiological Trends in an Endemic Region in Poland: A Retrospective Hospital-Based Study, 1988–2020

<b>Background/Objectives</b>: Tick-borne encephalitis (TBE) is a notifiable disease in Poland, with the highest incidence in the northeastern region. Although vaccination is highly effective, breakthrough infections occasionally occur. This study aimed to describe the clinical features o...

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Main Authors: Magdalena Sulik-Wakulińska, Kacper Toczyłowski, Sambor Grygorczuk
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Vaccines
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Online Access:https://www.mdpi.com/2076-393X/13/7/665
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author Magdalena Sulik-Wakulińska
Kacper Toczyłowski
Sambor Grygorczuk
author_facet Magdalena Sulik-Wakulińska
Kacper Toczyłowski
Sambor Grygorczuk
author_sort Magdalena Sulik-Wakulińska
collection DOAJ
description <b>Background/Objectives</b>: Tick-borne encephalitis (TBE) is a notifiable disease in Poland, with the highest incidence in the northeastern region. Although vaccination is highly effective, breakthrough infections occasionally occur. This study aimed to describe the clinical features of vaccinated and unvaccinated TBE cases, assess long-term hospitalization trends, and estimate vaccine effectiveness (VE) in a highly endemic region. <b>Methods</b>: We retrospectively analyzed 1518 laboratory-confirmed TBE cases hospitalized at the University Clinical Hospital in Białystok, Poland, from 1988 to 2020. Clinical and cerebrospinal fluid (CSF) parameters were compared between vaccinated and unvaccinated individuals. Vaccine effectiveness was estimated using the screening method, based on aggregated regional vaccine uptake data from 1999 to 2020. <b>Results</b>: Among all cases, 13 (0.9%) occurred in individuals who had received at least one dose of vaccine, including 4 who had completed the full primary vaccination schedule. Hospitalized vaccinated patients showed similar demographic and clinical characteristics compared to unvaccinated patients, though CSF findings suggested an earlier and more dynamic immune response. Seasonal analysis revealed a sustained increase in TBE hospitalizations and a possible extension of the transmission season into late summer and autumn. Estimated VE was 94.4% (95% CI 85.2–97.9%), though this should be interpreted with caution due to the small number of vaccinated cases and assumptions regarding population-level coverage. <b>Conclusions</b>: This study provides detailed clinical data on breakthrough TBE cases and long-term epidemiological insights from an endemic region in Poland. While vaccine effectiveness appears high, low uptake remains a public health concern. These findings underscore the need for improved vaccination coverage and ongoing surveillance to monitor evolving transmission patterns.
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spelling doaj-art-b49942e34c3741a68ca53d8de7c50eef2025-08-20T03:13:54ZengMDPI AGVaccines2076-393X2025-06-0113766510.3390/vaccines13070665Breakthrough Tick-Borne Encephalitis and Epidemiological Trends in an Endemic Region in Poland: A Retrospective Hospital-Based Study, 1988–2020Magdalena Sulik-Wakulińska0Kacper Toczyłowski1Sambor Grygorczuk2Department of Infectious Diseases and Neuroinfections, Medical University in Białystok, Żurawia 14, 15-540 Białystok, PolandDepartment of Pediatric Infectious Diseases, Medical University in Białystok, Waszyngtona 17, 15-274 Białystok, PolandDepartment of Infectious Diseases and Neuroinfections, Medical University in Białystok, Żurawia 14, 15-540 Białystok, Poland<b>Background/Objectives</b>: Tick-borne encephalitis (TBE) is a notifiable disease in Poland, with the highest incidence in the northeastern region. Although vaccination is highly effective, breakthrough infections occasionally occur. This study aimed to describe the clinical features of vaccinated and unvaccinated TBE cases, assess long-term hospitalization trends, and estimate vaccine effectiveness (VE) in a highly endemic region. <b>Methods</b>: We retrospectively analyzed 1518 laboratory-confirmed TBE cases hospitalized at the University Clinical Hospital in Białystok, Poland, from 1988 to 2020. Clinical and cerebrospinal fluid (CSF) parameters were compared between vaccinated and unvaccinated individuals. Vaccine effectiveness was estimated using the screening method, based on aggregated regional vaccine uptake data from 1999 to 2020. <b>Results</b>: Among all cases, 13 (0.9%) occurred in individuals who had received at least one dose of vaccine, including 4 who had completed the full primary vaccination schedule. Hospitalized vaccinated patients showed similar demographic and clinical characteristics compared to unvaccinated patients, though CSF findings suggested an earlier and more dynamic immune response. Seasonal analysis revealed a sustained increase in TBE hospitalizations and a possible extension of the transmission season into late summer and autumn. Estimated VE was 94.4% (95% CI 85.2–97.9%), though this should be interpreted with caution due to the small number of vaccinated cases and assumptions regarding population-level coverage. <b>Conclusions</b>: This study provides detailed clinical data on breakthrough TBE cases and long-term epidemiological insights from an endemic region in Poland. While vaccine effectiveness appears high, low uptake remains a public health concern. These findings underscore the need for improved vaccination coverage and ongoing surveillance to monitor evolving transmission patterns.https://www.mdpi.com/2076-393X/13/7/665tick-borne encephalitisvaccine effectivenessbreakthrough infection
spellingShingle Magdalena Sulik-Wakulińska
Kacper Toczyłowski
Sambor Grygorczuk
Breakthrough Tick-Borne Encephalitis and Epidemiological Trends in an Endemic Region in Poland: A Retrospective Hospital-Based Study, 1988–2020
Vaccines
tick-borne encephalitis
vaccine effectiveness
breakthrough infection
title Breakthrough Tick-Borne Encephalitis and Epidemiological Trends in an Endemic Region in Poland: A Retrospective Hospital-Based Study, 1988–2020
title_full Breakthrough Tick-Borne Encephalitis and Epidemiological Trends in an Endemic Region in Poland: A Retrospective Hospital-Based Study, 1988–2020
title_fullStr Breakthrough Tick-Borne Encephalitis and Epidemiological Trends in an Endemic Region in Poland: A Retrospective Hospital-Based Study, 1988–2020
title_full_unstemmed Breakthrough Tick-Borne Encephalitis and Epidemiological Trends in an Endemic Region in Poland: A Retrospective Hospital-Based Study, 1988–2020
title_short Breakthrough Tick-Borne Encephalitis and Epidemiological Trends in an Endemic Region in Poland: A Retrospective Hospital-Based Study, 1988–2020
title_sort breakthrough tick borne encephalitis and epidemiological trends in an endemic region in poland a retrospective hospital based study 1988 2020
topic tick-borne encephalitis
vaccine effectiveness
breakthrough infection
url https://www.mdpi.com/2076-393X/13/7/665
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AT kacpertoczyłowski breakthroughtickborneencephalitisandepidemiologicaltrendsinanendemicregioninpolandaretrospectivehospitalbasedstudy19882020
AT samborgrygorczuk breakthroughtickborneencephalitisandepidemiologicaltrendsinanendemicregioninpolandaretrospectivehospitalbasedstudy19882020