Prepared by: Luka Kosec Last modified: March 2025


Purpose and justification of the indicator

Diphtheria, tetanus, whooping cough and Haemophilus influenzae type b are caused by bacteria, while polio and hepatitis B are caused by viruses. All of these infections, except tetanus, are transmitted from person to person. The tetanus bacillus, which is present in the soil, enters the body through injuries or wounds. DIFFICULTIES is a respiratory disease that causes sore throat. Membranous deposits can form in the throat, larynx, and trachea, making breathing difficult. The disease can also cause other complications, such as heart rhythm disturbances, heart failure, paralysis, and death. TETANUS is a disease that affects the nervous system. The disease is characterized by muscle spasms, ranging from spasms of the chewing muscles to generalized spasms throughout the body. The brain centers that control breathing and the proper functioning of the heart can also be affected. Despite treatment, the disease can end in death. WHOOPING COUGH is characterized by severe coughing fits and subsequent difficulty breathing. The illness can last for several weeks. The spasmodic cough can cause vomiting. In more severe cases, children have difficulty eating, drinking, and breathing. Possible complications include pneumonia, febrile seizures, brain hemorrhage, and death. Infection with HAEMOPHILUS INFLUENZAE TYPE B (Hib) bacteria can cause several serious forms of illness, most commonly pneumonia and meningitis. Infection can lead to serious complications such as mental retardation, cerebral palsy, deafness, epilepsy or partial blindness. Most poliovirus infections that cause INDONESIAN PARALYSIS are asymptomatic. In people with signs of infection, polio begins as a flu-like illness, followed by paralysis of the limbs (the patient cannot move their arms or legs) and severe muscle pain. Death occurs from paralysis of the respiratory muscles. Signs of HEPATITIS B include fatigue, diarrhea, vomiting, jaundice. The infection can also occur without any health problems, and the person may not know they are infected, but they are a carrier and can spread the infection to other people. Later in the course of the disease, chronic inflammation or liver cancer may occur. Vaccination with the hexavalent vaccine (DTP-Hib-IPV-hepB) provides early and comprehensive protection against diseases caused by bacteria and viruses, such as diphtheria (D), tetanus (T), pertussis (P), Haemophilus influenzae type b (Hib), polio (IPV) and hepatitis B (hepB). According to the National Vaccination Program in Slovenia, vaccination against DTP-Hib-IPV-hepB is one of the mandatory vaccinations. All infants, including premature babies, must receive three doses of the vaccine. Vaccination begins at the age of three months, the second dose is given at five months, and the third dose is given at 11 to 18 months of age. Vaccination according to the national program ensures that children receive protection in the earliest period of life, when they are most vulnerable to infections. Combined vaccines provide protection against multiple diseases with a single injection, reducing the number of applications and thus the number of visits to health facilities. Extensive studies have confirmed the effectiveness of the 6-valent vaccine in preventing the diseases listed above. However, adverse effects of the vaccine are usually mild and transient, with local reactions at the vaccination site being the most common.

Definition of indicator

Vaccination coverage of children against DTP-Hib-IPV-HepB in the observed period describes the proportion of children from a specific birth cohort for whom vaccination against diphtheria, tetanus, pertussis, Haemophilus influenzae type b, polio and hepatitis B is prescribed in accordance with the National Vaccination Program, who were vaccinated with three doses of the DTP-Hib-IPV-HepB vaccine, calculated as a percentage of all children from the same birth cohort.

Unit of measure

Calculation of the indicator

The vaccination coverage of children against DTP-Hib-IPV-HepB is the ratio of the number of children from a given birth cohort who have been vaccinated with three doses of the DTP-Hib-IPV-HepB vaccine to the total number of children from that same birth cohort. Vaccination of children with 3 doses of DTP-Hib-IPV-HepB vaccine (FORMULA) The calculation of the indicator takes into account all children who meet the above conditions, are registered in eRCO and have a temporary or permanent address of residence in Slovenia. Vaccination coverage by municipality is shown according to address of residence.

Data sources for Slovenia

eRCO – Electronic registry of vaccinated persons and adverse reactions after vaccination.

Time availability

Year of publication of the indicator in Health in the municipality

Reference year 2023 (children born in 2021), annually

Men in literature

1. National Institute of Public Health. Basic information on vaccination against diphtheria, tetanus, pertussis, Haemophilus influenzae type b, polio and hepatitis B [internet]. [cited on 24. 9. 2024]. Available at: 2019_dtphibipvhepb_6.pdf (nijz.si). 2. Özen M, Ünüvar E, Yıldırım A, Akman H, Mevlitoğlu S, Pehlivan T. A worldwide overview for hexavalent vaccines and a glimpse into Turkey&#39;s perspective. Hum Vaccine Immunother. 2024 Dec 31;20(1):2345493. 3. Bulik, N.-B., Bucșa, C., Farcaș, A., &amp; Oniga, O. Hexavalent vaccine in Europe: Safety data from the randomized clinical trials. Farmacia Journal. 2018 Oct 13; 66(5). Orsi A, Azzari C, Bozzola E, Chiamenti G, Chirico G, Esposito S, Francia F, Lopalco P, Prato R, Russo R, Villani A, Franco E. Hexavalent vaccines: characteristics of available products and practical considerations from a panel of Italian experts. J Prev Med Hyg. 2018 Jun 1;59(2):E107-E119.

Notes

It is assumed that all children from a given birth cohort had the opportunity to be vaccinated by the reference period to which the data refer (e.g.: for the reference year 2023, this is the cohort of children born from 1 January to 31 December 2021). Reporting on vaccinations in eRCO is not optimal, so the vaccination coverage shown in this indicator is slightly underestimated compared to the actual vaccination coverage of children against DTP-Hib-IPV-HepB in Slovenia. Therefore, at the National Institute of Public Health, we additionally check the vaccination coverage of children against DTP-Hib-IPV-HepB with 3 doses of the vaccine on a random sample of children every year.

Preventive

Prepared by: Metka Zaletel 
Date of last modification: September 2016

Residents and community

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Health risk factors

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Prepared by: Sonja Tomšič 
Date of last change: November 2019

Prepared by: Luka Kosec Last modified: March 2025

Prepared by: Sonja Tomšič 
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Health status

Prepared by: Victoria Zakrajšek 
Date of last change: March 2017

Prepared by: Aleš Korošec 
Date of last change: September 2016

Prepared by: Aleš Korošec
Date of last change: September 2016

Prepared by: Tatjana Kofol Bric 
Date of last change: March 2019

Prepared by: Aleš Korošec and Sonja Tomšič 
Date of last change: September 2016

Prepared by: Mojca Simončič and Metka Zaletel 
Date of last change: October 2019

Prepared by: Kristina Orožen 
Date of last change: March 2019

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Mortality

Prepared by: Sonja Tomšič, Tatjana Kofol Bric 
Date of last change: March 2019

Prepared by: Sonja Tomšič 
Date of last change: March 2019

Prepared by: Tina Lesnik 
Date of last change: March 2019

Prepared by: Tina Lesnik 
Date of last change: March 2020