*11.3.1. Recommendations for TBE vaccination*

Given that TBE occurrence varies within and between individual endemic areas, vaccination strategies need to incorporate risk assessments for a particular region. According to WHO recommendations [133], in highly endemic TBE regions (≥5 cases/100,000/year) vaccination should be offered to whole population, including children, whereas in regions with a moderate or low TBE incidence (<5 cases/100,000/year), immunization has to target individuals at risk, i.e., those having outdoor activities or working under high-risk conditions. Travelers from non-endemic to endemic areas should be vaccinated if extensive outdoor activities are expected [133–136].

Similarly, Central European Vaccination Awareness Group (CEVAG) strongly recommends the introduction of universal TBE vaccination for persons >1‐year old for all countries at high risk of TBE [135]. Persons who had acquired TBE do not need vaccination as they are appreciated to be protected against the disease.

#### *11.3.2. Vaccines*

In Europe two vaccines against TBE are registered: FSME‐IMMUN® and Encepur® (in some countries named TicoVac). Both contain inactivated European subtype of TBEV (strain Neudorf 1 and strain K23, respectively), are prepared in a similar way (viruses are grown in chick embryo fibroblast cells, are inactivated by formaldehyde and are purified, adjuvant is aluminum hydroxide), are registered for adults and children aged 1 year and older (vaccines for children are called FSME‐IMMUN 0.25 ml Junior, and Encepur Kinder, respectively), and effectively prevent TBE caused by the European as well as Far-Eastern and Siberian subtype of TBEV [131].

In addition to the European vaccines, three vaccines based on Far-Eastern subtype of TBEV are registered: two are produced in Russia (TBE‐Moscow and EnceVir) and one in China [131].
