Progress Toward Measles Elimination - European Region, 2009-2018

Abstract

In 2010, all 53 countries* in the World Health Organization (WHO) European Region (EUR) reconfirmed their commitment to eliminating measles and rubella and congenital rubella syndrome (1); this goal was included as a priority in the European Vaccine Action Plan 2015-2020 (2). The WHO-recommended elimination strategies in EUR include 1) achieving and maintaining ≥95% coverage with 2 doses of measles-containing vaccine (MCV) through routine immunization services; 2) providing measles and rubella vaccination opportunities, including supplementary immunization activities (SIAs), to populations susceptible to measles or rubella; 3) strengthening surveillance by conducting case investigations and confirming suspected cases and outbreaks with laboratory results; and 4) improving the availability and use of evidence for the benefits and risks associated with vaccination (3). This report updates a previous report (4) and describes progress toward measles elimination in EUR during 2009-2018. During 2009-2017, estimated regional coverage with the first MCV dose (MCV1) was 93%-95%, and coverage with the second dose (MCV2) increased from 73% to 90%. In 2017, 30 (57%) countries achieved ≥95% MCV1 coverage, and 15 (28%) achieved ≥95% coverage with both doses. During 2009-2018, >16 million persons were vaccinated during SIAs in 13 (24%) countries. Measles incidence declined to 5.8 per 1 million population in 2016, but increased to 89.5 in 2018, because of large outbreaks in several EUR countries. To achieve measles elimination in EUR, measures are needed to strengthen immunization programs by ensuring ≥95% 2-dose MCV coverage in every district of each country, offering supplemental measles vaccination to susceptible adults, maintaining high-quality surveillance for rapid case detection and confirmation, and ensuring effective outbreak preparedness and response.

FIGURE

Estimated coverage with the first and second doses of measles-containing vaccine and the number of confirmed measles cases — World Health Organization (WHO) European Region, 2009–2018 Abbreviations: MCV1 = first dose of a measles-containing vaccine; MCV2 = second dose of a measles-containing vaccine. * WHO and United Nations Children’s Fund estimates, July 15, 2018, update. https://www.who.int/immunization/monitoring_surveillance/data/en/. ^† Cases reported to WHO, as of March 1, 2019. https://www.who.int/immunization/monitoring_surveillance/data/en/. ^§ Date range for estimated coverage = 2009–2017; date range for confirmed measles cases = 2009–2018.