Background: Starting from 2016, a major measles epidemic affected EU/EEA countries, after the measles incidence rate had progressively decreased from 2011 to 2015. Methods: This study describes measles incidences (ECDC reports), the vaccination coverages (VCs) (WHO/UNICEF reports) and the vaccination strategies, whether mandatory or recommended (ECDC Vaccine Scheduler), in 30 European countries over the last decade. Results: VCs were higher in countries with historically mandatory vaccination. However, in these countries, VCs declined between 2010 and 2018, in two cases to levels below 90% at the second dose. Instead, 9 and 12 countries with recommended vaccination increased their VCs, respectively, for the first and the second dose. Overall, the countries with VC ≥ 95% decreased from 20 to 15 for the first dose and from 10 to 7 for the second dose. This trend led Italy, France and Germany to make vaccination mandatory. In Italy this provision was introduced in 2017, and together with the catch-up campaigns on children between 1 and 15 years at school entry, led immediately to a strong effect: the first dose VC passed from 87% in 2016 to 93% in 2018, and from 82% to 89% for the second dose. Conclusions: Mandatory vaccination is certainly a policy producing positive effects; however, it seems to require additional strategies in order to reach the WHO goal of 95% of VC. Measures such as catch-up action on susceptible populations and communication strategies aimed at increasing awareness and acceptance should be considered.

Measles Immunization Policies and Vaccination Coverage in EU/EEA Countries over the Last Decade

Marco Montalti
Primo
Formal Analysis
;
Erica Leoni
Penultimo
Supervision
;
Laura Dallolio
Ultimo
Conceptualization
2020

Abstract

Background: Starting from 2016, a major measles epidemic affected EU/EEA countries, after the measles incidence rate had progressively decreased from 2011 to 2015. Methods: This study describes measles incidences (ECDC reports), the vaccination coverages (VCs) (WHO/UNICEF reports) and the vaccination strategies, whether mandatory or recommended (ECDC Vaccine Scheduler), in 30 European countries over the last decade. Results: VCs were higher in countries with historically mandatory vaccination. However, in these countries, VCs declined between 2010 and 2018, in two cases to levels below 90% at the second dose. Instead, 9 and 12 countries with recommended vaccination increased their VCs, respectively, for the first and the second dose. Overall, the countries with VC ≥ 95% decreased from 20 to 15 for the first dose and from 10 to 7 for the second dose. This trend led Italy, France and Germany to make vaccination mandatory. In Italy this provision was introduced in 2017, and together with the catch-up campaigns on children between 1 and 15 years at school entry, led immediately to a strong effect: the first dose VC passed from 87% in 2016 to 93% in 2018, and from 82% to 89% for the second dose. Conclusions: Mandatory vaccination is certainly a policy producing positive effects; however, it seems to require additional strategies in order to reach the WHO goal of 95% of VC. Measures such as catch-up action on susceptible populations and communication strategies aimed at increasing awareness and acceptance should be considered.
2020
Marco Montalti, Anna Kawalec, Erica Leoni, Laura Dallolio
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/804203
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