Europe is grappling with a significant resurgence of measles, with reported cases doubling last year to levels not seen in nearly three decades. A joint analysis released Thursday by the World Health Association (WHO) and Unicef reveals that 127,350 cases of measles and at least 38 deaths were reported across 53 countries in Europe and Central Asia in 2023. This alarming spike is largely attributed to disruptions in routine vaccinations due to the Covid-19 pandemic and the spread of misinformation concerning vaccine safety and effectiveness.

The WHO and Unicef report emphasizes the urgent need to address vaccination gaps and combat the proliferation of false information to safeguard vulnerable populations from this highly contagious and potentially life-threatening disease. The vast majority of individuals infected with measles last year were either unvaccinated or had an unknown vaccination status, underscoring the direct correlation between vaccination rates and disease prevalence.

Hans Henri P. Kluge, WHO’s regional director for Europe, stressed the gravity of the situation, stating, Measles is back, and it’s a wake-up call. He further emphasized the critical importance of widespread vaccination, adding, Without high vaccination rates, there is no health security.

The European region accounted for a third of the world’s reported measles cases last year. Romania experienced the highest number of cases, with 30,692 reported. russia and Kazakhstan also reported significant numbers of cases, contributing to the overall surge in the region.

The United Kingdom also witnessed a considerable increase in measles cases, with 2,900 reported last year. Within the European Union, Italy reported the second-highest number of cases at 1,057, followed by Germany with 647, Austria with 555, and Belgium with 531.

Fatima Čengić, Unicef’s chief of immunisation for Europe and Central asia, described the situation as a significant setback in children’s health progress. We were talking about thriving. Now all of a sudden we have to go back to survival, she lamented,highlighting the urgent need to refocus efforts on combating this preventable disease.

The impact of the measles outbreak is notably severe among young children. Across Europe, more than 50,000 cases involved children under the age of five.The severity of the illness is underscored by the fact that approximately 60% of all those infected required hospitalization. Measles can lead to serious complications, including pneumonia, brain swelling, and blindness, particularly in young children and individuals with weakened immune systems.

Health officials have identified declining vaccination rates as a primary driver of the measles resurgence. between 2019 and 2023, the number of children receiving their first dose of the measles vaccine dropped by 10%. In 2023 alone, half a million eligible children in Europe missed their first dose of the measles vaccine.

Čengić explained that disruptions to routine vaccinations due to overburdened healthcare systems during the pandemic contributed to the decline in vaccination rates. So we’ve been calling on governments to do a catchup – to find all the children who didn’t get a vaccination and make sure they are getting vaccinated, she said.

The spread of misinformation about vaccines has also played a significant role in declining vaccination rates. Čengić noted, Covid-19 seemed to have brought out a lot of misinformation, particularly on covid-19, but then there was a spillover affect to the routine immunisation.

She urged parents to seek information from credible sources, cautioning, We need to make sure that parents do understand that they need to look at the credible sources. You cannot just do a Google search on vaccination. That’s not how it effectively works.

The impact of anti-vaccination sentiment is evident in Romania, where measles cases have surged dramatically. A report by the Center for European Policy Analysis noted that three political parties that entered parliament in the recent election espoused anti-vaccination narratives, highlighting the growing threat of “medical populism.”

Data from the WHO and Unicef reveals a concerning decline in measles vaccination coverage in Romania. Between 2013 and 2023, the percentage of the population who had their first dose of the measles vaccine dropped from 92% to 78%, substantially below the 95% coverage rate required to maintain herd immunity.

The analysis also highlighted critically low first-dose vaccination rates in Bosnia and Herzegovina, which reported a coverage rate of 55% in 2023, and in montenegro, where coverage was just 24% last year.

The situation in Europe mirrors concerns in the United States, where a measles outbreak in Texas has resulted in the deaths of two people – the first from measles in nearly a decade. Health officials anticipate the outbreak, which has already affected at least 250 people, to expand rapidly.

Conclusion

The resurgence of measles in Europe serves as a stark reminder of the importance of maintaining high vaccination rates and combating misinformation. the WHO and Unicef’s joint analysis underscores the urgent need for governments and health organizations to prioritize catch-up vaccination campaigns, address vaccine hesitancy, and ensure access to credible information to protect vulnerable populations from this preventable disease. Failure to do so risks further outbreaks and potentially devastating consequences, particularly for young children.

Is the recent surge in measles cases across Europe a harbinger of a larger global health crisis? The answer, according to leading immunologist Dr. Evelyn Reed, is a resounding yes.

Interviewer: Dr. Reed,thank you for joining us today. The World Health Organization and UNICEF have reported a three-decade high in measles cases in Europe. What are the primary factors driving this alarming resurgence?

Dr. Reed: The recent surge in measles cases across europe and other regions highlights a critical issue: the erosion of population immunity due to several interconnected factors. Firstly, the COVID-19 pandemic dramatically disrupted routine vaccination programs globally. With healthcare systems overwhelmed and access to routine care hampered for many, numerous children missed their scheduled measles-mumps-rubella (MMR) vaccinations. This created a cohort of unvaccinated or partially vaccinated individuals, making them susceptible to measles infection. Secondly, the propagation of misinformation regarding vaccine safety and effectiveness continues to fuel vaccine hesitancy. This undermines public confidence in the efficacy of one of the most accomplished and life-saving vaccines in human history.

Interviewer: The report points to strikingly low vaccination rates in some european countries. How does the failure to achieve herd immunity contribute to outbreaks like this?

Dr. Reed: Achieving herd immunity, where a critical percentage of the population is immune to a disease, substantially protects even those who can’t receive the vaccine due to health reasons. The World Health Organization (WHO) generally recommends vaccination coverage of approximately 95% to achieve this protection against many infectious diseases, including measles. When vaccination rates fall below this threshold, as seen in various European nations, the virus finds fertile ground to spread, resulting in increased cases, hospitalizations, and even fatalities. The current decline in measles vaccination coverage,coupled with the disrupted vaccine schedules caused by several simultaneous factors,is an alarming indication of how quickly we can loose epidemiological control of a highly preventable disease.

Interviewer: The report highlights the disproportionate impact on young children. Can you elaborate on the severity of measles infection in this vulnerable population?

Dr. Reed: Measles is especially risky for young children, and infants under six months old are especially vulnerable. Their immune systems are still developing, limiting their capacity to fight off the infection effectively. Severe complications such as pneumonia,encephalitis (brain swelling),and blindness can occur. Measles can also permanently damage an already forming immune system. The rate of hospitalization among those infected is significantly high, underlining the seriousness of even “mild” measles cases in young children.

Interviewer: Beyond Europe, other regions are experiencing similar challenges. Does the European experience serve as a warning sign for the rest of the world?

Dr. Reed: Absolutely. This European measles outbreak acts as a harsh wake-up call. The factors driving this resurgence—pandemic-related disruptions, anti-vaccine misinformation, and inadequate vaccination coverage—are not unique to Europe. Many countries globally face comparable challenges, making them vulnerable to experiencing similar outbreaks. This highlights the interconnectedness of global health security and the need for coordinated, continuous efforts to maintain and improve childhood immunization worldwide.

Interviewer: What concrete steps can governments and health organizations take to prevent future outbreaks?

Dr. reed: To avert future outbreaks, concerted efforts are essential.These include:

Strengthening routine immunization programs: Ensuring access to and uptake of vaccines for all children through dedicated vaccination campaigns and overcoming logistical barriers.

Combating vaccine hesitancy and misinformation: Implementing complete public health communications that address common concerns through credible sources and fact-checks. Educating healthcare providers,parents,and community leaders on the importance and safety of vaccines is paramount.

strengthening healthcare systems: Ensuring strong surveillance systems to quickly detect and respond to outbreaks, including those of rare or underestimated magnitude.

Promoting international collaboration: Sharing best practices, data, and resources to effectively manage and mitigate the threat of vaccine-preventable diseases.

Interviewer: what is the overarching message you’d like to leave our readers with?

dr. Reed: measles is a preventable disease. The resurgence we are witnessing is not inevitable; it’s a consequence of preventable failures in public health preparedness. maintaining high vaccination coverage through effective public health strategies and actively addressing vaccine hesitancy are paramount to protecting communities from this perhaps devastating disease. We must never forget the lessons learned from the past and act aggressively to protect the health and well-being of future generations. Now is the time to reinvest in preventable disease prevention.

Let’s discuss further. What are your thoughts on the urgent need for improved vaccination programs and combating misinformation? Share your comments below and join the conversation on social media!