The 19th meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) - a group of neurologists, general practitioners, clinicians, travel physicians, virologists, pediatricians and epidemiologists-was held under the title "TBE in a changing world". Key topics within virology, current epidemiological developments and investigations, expansion of risk areas, clinical aspects and cases, traveling and mobility, vaccination rates, and latest news on vaccination were presented and extensively discussed. Over the past four decades, TBE has become a growing public health challenge in Europe and parts of Asia. It may be considered a complex eco-epidemiological system, characterized by an intricate interplay between the virus, ticks and tick hosts on the one hand and human exposure strongly influenced by socioeconomic conditions on the other hand. Although the facts are simple - vaccination is the best prevention - the socioeconomic conditions keep changing, and with them the ability or willingness of people to get vaccinated.