Measles still spreads in Europe: who is responsible for the failure to vaccinate?

All countries in the European Region of the World Health Organization (WHO) have renewed their commitment to eliminate measles transmission by 2015. Measles elimination is a feasible target but requires vaccination coverage above 95% with two doses of a measles-mumps-rubella vaccine (MMR) in all population groups and in all geographical areas. Measles has re-emerged in the EU recently, due to suboptimal immunization levels that led to accumulation of susceptible populations over the last years. In fact, while an overall decreasing trend had been observed until 2009, the number of cases increased by a factor of four between 2010 and 2011. According to vaccination coverage data reported to the WHO, between 2000 and 2010, almost 5 million individuals in the EU in the age group 2-12 had not had MMR vaccination. Catch-up vaccination activities for susceptible populations are paramount in order to reach the elimination goal, but only feasible if a multi-component approach is put in place quickly and efficiently. Advocacy and communication are key strategic areas.

[1]  K Reesten M Eldgaard,et al.  A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism , 2002 .

[2]  M. Kojouharova,et al.  An ongoing measles outbreak in Bulgaria, 2009. , 2009, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[3]  A. Kata.  Anti-vaccine activists, Web 2.0, and the postmodern paradigm--an overview of tactics and tropes used online by the anti-vaccination movement. , 2012, Vaccine.

[4]  P. Stefanoff,et al.  Mass immunisation campaign in a Roma settled community created an opportunity to estimate its size and measles vaccination uptake, Poland, 2009. , 2010, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[5]  R. Majewska,et al.  Lack of Association Between Measles-Mumps-Rubella Vaccination and Autism in Children: A Case-Control Study , 2010, The Pediatric infectious disease journal.

[6]  J. Stockman.  Measles in Europe: an epidemiological assessment , 2010 .

[7]  M. Muscat.  Who gets measles in Europe? , 2011, The Journal of infectious diseases.

[8]  A. Kata.  A postmodern Pandora's box: anti-vaccination misinformation on the Internet. , 2010, Vaccine.

[9]  V. Hutse,et al.  An outbreak of measles in orthodox Jewish communities in Antwerp, Belgium, 2007-2008: different reasons for accumulation of susceptibles. , 2009, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[10]  I. Stirling,et al.  Chlorinated Hydrocarbon Contaminants in Polar Bears from Eastern Russia, North America, Greenland, and Svalbard: Biomonitoring of Arctic Pollution , 1998, Archives of environmental contamination and toxicology.

[11]  S. Kasper,et al.  Measles outbreak in Styria, Austria, March-May 2009. , 2009, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[12]  J. Mossong,et al.  Towards elimination: measles susceptibility in Australia and 17 European countries. , 2008, Bulletin of the World Health Organization.

[13]  Jun Li,et al.  Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association , 1999, The Lancet.

[14]  A. Wakefield,et al.  Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. , 1998, Lancet.

[15]  A. Mankertz,et al.  Spotlight on measles 2010: An epidemiological overview of measles outbreaks in Poland in relation to the measles elimination goal. , 2010, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[16]  M. Ramsay,et al.  MMR vaccine coverage in the UK falls after adverse publicity , 1998 .

[17]  P. Stefanoff,et al.  Spotlight on measles 2010: A measles outbreak in a Roma population in Pulawy, eastern Poland, June to August 2009. , 2010, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[18]  M. Muscat,et al.  An update on an ongoing measles outbreak in Bulgaria, April-November 2009. , 2009, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[19]  C. Betsch.  Innovations in communication: the Internet and the psychology of vaccination decisions. , 2011, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[20]  B. Deer,et al.  How the case against the MMR vaccine was fixed , 2011, BMJ : British Medical Journal.

[21]  Frank Renkewitz,et al.  The Influence of Vaccine-critical Websites on Perceiving Vaccination Risks , 2010, Journal of health psychology.

[22]  E. Ernst.  The attitude against immunisation within some branches of complementary medicine , 1997, European Journal of Pediatrics.

[23]  E. Bechter,et al.  Measles outbreak linked to a minority group in Austria, 2008 , 2009, Epidemiology and Infection.