Ensuring Every Dose Matters: Protecting the Success of Vaccination Efforts Across Europe

As Europe commemorates European Immunization Week (EIW) 2025, the European Centre for Disease Prevention and Control (ECDC) issues a stark warning about the mounting dangers posed by suboptimal vaccination coverage across the European Union and European Economic Area (EU/EEA). Recent surveillance data reveal a troubling resurgence of measles infections, alongside alarming detections of vaccine-derived poliovirus in several countries—a potent reminder that the advances made in controlling and eradicating vaccine-preventable diseases are at serious risk if immunization efforts falter.

The dramatic increase in measles cases—nearly tenfold in 2024 compared to previous years—reflects deeply entrenched immunity gaps resulting from declining vaccination uptake. Despite global recognition of vaccines as one of the most powerful public health tools, preventing illnesses like measles, polio, diphtheria, and pertussis, Europe is confronting the consequences of uneven vaccine acceptance. In 2024, more than 35,000 measles cases were reported in the EU/EEA, with 23 fatalities, including 14 children under five years old, underscoring the lethal potential of the disease in vulnerable populations.

Measles virus, a highly contagious paramyxovirus, requires sustained high coverage of the measles-mumps-rubella (MMR) vaccine to interrupt transmission. The threshold to maintain herd immunity is estimated at 95% coverage with two doses. However, current vaccination rates across most EU/EEA nations fall below this critical level. Only Hungary, Malta, Portugal, and Slovakia have reported meeting or exceeding this benchmark recently. This deficit fosters ongoing pockets of susceptibility that allow outbreaks to ignite and proliferate, endangering unvaccinated individuals and those who cannot be vaccinated due to medical contraindications.

ECDC’s epidemiological analysis further highlights that the demographic impact of measles extends beyond children. Approximately 26% of cases in 2024 were individuals aged 15 and older, illustrating that immunity gaps persist into adolescence and adulthood. This shift in age distribution may reflect a cohort effect with waning immunity in older age groups or missed vaccinations during earlier life stages, emphasizing the importance of catch-up immunization campaigns targeting these populations.

Equally concerning is the detection of circulating vaccine-derived poliovirus type 2 (cVDPV2) in sewage samples from Finland, Germany, Poland, Spain, and the United Kingdom between September and December 2024. While no paralytic poliomyelitis cases have emerged in humans, the presence of cVDPV2 signals that vaccine-derived polioviruses can spread in under-immunized populations. The attenuated oral polio vaccine, widely used in global eradication efforts, can rarely revert to neurovirulent forms in settings with insufficient vaccination coverage, necessitating vigilant surveillance and robust immunization programs to preclude resurgence.

The risk posed by both measles and poliovirus elucidates the broader public health imperative: comprehensive immunization must be safeguarded to preserve the collective protection conferred by high vaccine uptake. The fragility of herd immunity means that even small declines in vaccination rates can precipitate outbreaks, burden health systems, and cause preventable morbidity and mortality.

ECDC underscores that maintaining and improving immunization coverage requires multifaceted approaches rooted in social and behavioral sciences. Understanding vaccine hesitancy—an intricate phenomenon shaped by individual beliefs, societal norms, misinformation, and trust in health authorities—is critical to crafting interventions that resonate with diverse communities. Tailoring strategies to address specific barriers and facilitators within populations forms the cornerstone of enhancing acceptance and uptake.

In support of national immunization efforts, ECDC has published a comprehensive report detailing operational tools and methodologies drawn from social and behavioral science frameworks. These resources equip public health practitioners with adaptable interventions designed to overcome vaccine hesitancy, counteract misinformation, and engage vulnerable or hard-to-reach groups effectively. The report emphasizes real-world applicability, enabling tailored approaches that reflect local contexts and cultural nuances.

In parallel with behavioral interventions, the role of digital immunization information systems is paramount. Modernized, interoperable digital registries enable health authorities to identify unvaccinated individuals, monitor coverage in real-time, and coordinate targeted outreach and catch-up campaigns. Such technological infrastructure is essential for optimizing immunization program performance and rapidly responding to emerging immunity gaps.

Sustained investment at both EU and national levels remains crucial for high-quality disease surveillance and prompt outbreak investigation capacities. Continuous data collection on vaccine-preventable diseases allows epidemiologists to detect transmission patterns, evaluate vaccination program effectiveness, and guide strategic decisions. Surveillance data drive risk assessment, inform public messaging, and support timely public health responses that mitigate the impact of outbreaks.

The resurgence of measles and detection of vaccine-derived poliovirus signify clear and urgent signals to policy makers and health authorities: the immunization gains of previous decades can be eroded swiftly without persistent vigilance. Countries must deploy a coordinated effort combining scientific insight, health communication, technological innovation, and community engagement to close vaccination gaps.

As Director of ECDC Pamela Rendi-Wagner articulates, “Thanks to vaccination we have eradicated smallpox and controlled serious diseases, such as polio, diphtheria and tetanus. The challenge for immunisation today is how to safeguard these gains. Accelerated efforts are needed to sustain high vaccination coverage. Every vaccine dose counts, and timing matters for optimal protection.” Her statement encapsulates the critical juncture at which Europe stands—a moment demanding renewed commitment to immunization as a foundation of public health security.

The EIW 2025 digital event organized by ECDC further aims to unify epidemiology and social sciences, fostering dialogue and shared solutions to address vaccination barriers and immunity gaps. By bridging disciplines and harnessing collective expertise, this initiative seeks to enhance the resilience of immunization systems in the EU/EEA and ultimately protect every community from preventable infectious diseases.

In conclusion, the data and developments spotlighted by the ECDC serve as a compelling call to action: safeguarding public health in Europe hinges on closing immunization gaps through evidence-based, community-tailored interventions, fortified surveillance, and unwavering support for vaccination programs. Only through such concerted efforts can Europe avert the threat of vaccine-preventable disease resurgence and uphold the health of its populations for generations to come.

Subject of Research: Vaccine-preventable disease resurgence and immunization coverage in Europe

Article Title: Europe Faces Critical Immunization Challenges Amid Measles Surge and Poliovirus Detections, ECDC Warns

News Publication Date: April 27, 2025

Web References:

European Immunization Week 2025: https://www.who.int/europe/news-room/events/item/2025/04/27/default-calendar/european-immunization-week-2025
EIW 2025 Digital Event Registration: https://bit.ly/EIW2025Event

References:

ECDC Annual Epidemiological Report for 2024 (Available from 28 April 2025)
Tools and methods for promoting vaccination acceptance and uptake: a social and behavioural science approach (ECDC, 2025)

Image Credits: European Centre for Disease Prevention and Control (ECDC)

Keywords: Measles, Polio, Vaccination, Immunization coverage, Vaccine-derived poliovirus, Vaccine hesitancy, Public health, EU/EEA, Infectious diseases, Immunization gaps, Disease surveillance, Herd immunity

Tags: ECDC vaccination warningsEuropean Immunization Week 2025herd immunity challengesimportance of MMR vaccinemeasles mortality rates in childrenpreventing vaccine-preventable diseases in Europeprotecting vulnerable populations through vaccinationpublic health vaccination effortsresurgence of measles infectionsvaccination coverage in Europevaccine acceptance issues in EUvaccine-derived poliovirus detections