Immunity to diphtheria has fallen to critical level in Estonia

TALLINN – The Estonian Health Board said on Friday that although an effective vaccine against diphtheria has been available since the 1940s, immunization coverage in Estonia has fallen to a critical limit and local outbreaks may now also occur in our country.

The Health Board said there is a warning example from Latvia, where a family of four -- three children and one adult, all unvaccinated against the disease -- was hospitalized for diphtheria last week. One of the children needs intensive care.

Irina Filippova, the head of the infectious disease epidemiology department at the Estonian Health Board, said that although the last case of diphtheria in Estonia was registered in 2001, there is a real risk of the disease being brought into our country and spreading here due to extensive travel and low vaccination coverage.

"Diphtheria tends to be more severe especially in young children, which is why protecting them is particularly important. Unfortunately, vaccination coverage in all age groups is below the 95 percent recommended by the WHO. Therefore, we urge all parents to consider that the right decision can save their child's life, as diphtheria is a very dangerous infection that can be prevented and its spread can be controlled with vaccine," Filippova said.

According to the Health Board, only 72.3 percent of one-year-old children and 83.3 percent of two-year-olds in Estonia are vaccinated against diphtheria. Coverage with the first booster dose is 72.8 percent for three-year-olds, and coverage with the second dose is 63.4 percent for seven-year-olds. Of adults, only about 25 percent have updated their immune defenses on time.

The official described Latvia as a warning example, because last week's outbreak of diphtheria is not uncommon. In 2009-2023, 122 cases of diphtheria were recorded in Latvia, of which 10 were fatal. Meanwhile, vaccination coverage for diphtheria in Latvia is higher than in Estonia.

In 2023-2024, 174 cases of diphtheria were recorded in the countries of the European Union and the European Economic Area. Of these cases, 117 were registered in Germany, 14 in the Netherlands, 12 in Belgium, seven in the Czech Republic, four in Slovenia, three in Latvia, four in Norway, three in Sweden, two in Luxembourg, two in Slovakia and two in Spain.