Marking European Immunization Week (EIW) 2025, the European Centre for Disease Prevention and Control (ECDC) highlights the risks of suboptimal vaccination coverage in Europe and publishes a set of operational tools that public health authorities can use to improve vaccination acceptance and uptake. The tenfold surge of reported measles cases in the European Union and European Economic Area (EU/EEA) and the detection of vaccine-derived poliovirus in four EU/EEA countries in 2024 are two clear signals of the need to achieve and maintain high immunisation coverage to protect European populations.
Vaccines have saved millions of lives worldwide. Vaccination remains one of the most effective tools in public health, preventing diseases such as measles, polio, diphtheria and pertussis. Nevertheless, more than 35 000 people were diagnosed with measles in the EU/EEA in 2024 and 23 people – 14 of them children below five years of age – died following their measles infection.
"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," says Pamela Rendi-Wagner, Director of ECDC.
Today, ECDC releases new data [2] on the almost tenfold increase in measles infections recorded in the EU/EEA in 2024. The data demonstrate the long-term impact of declining vaccination uptake and immunity gaps: among people with known vaccination status who fell ill with measles in 2024, eight out of ten had not been immunised.
Measles can affect anyone who is unprotected – not only children, but adolescents and adults as well. More than a quarter (26%) of people diagnosed with measles in 2024 were over 14 years old.
To prevent measles outbreaks and protect populations vulnerable to the disease, at least 95% of the population eligible for vaccination should receive two doses of the measles, mumps and rubella (MMR) vaccine. However, vaccination levels in the EU/EEA still fall short of this target, with recent estimates showing that only four countries (Hungary, Malta, Portugal and Slovakia) report such coverage for both doses.
Europe needs to close existing immunisation gaps to stay healthy
ECDC estimates that around 600 000 children aged 12–23 months may have missed their full primary polio vaccination course between 2022 and 2023. Between September and December 2024, circulating vaccine-derived poliovirus type 2 was detected in sewage samples in Finland, Germany, Poland, Spain and the United Kingdom. To date, no human polio cases have been reported, and the EU/EEA continues to be polio free – but, to keep it that way, targeted catch-up campaigns and improved surveillance need to address existing vaccination gaps [3].
The evidence is clear: insufficient vaccination coverage leaves too many people vulnerable to the disease, including children who are too young to be vaccinated and people who cannot receive vaccines due to medical reasons. Protecting these groups depends on high vaccination uptake in the general population eligible for vaccination.
Successful vaccination programmes are built on understanding and responding to people's beliefs, concerns, and expectations. Understanding the social and behavioural barriers and facilitators to vaccination is essential to design effective strategies and interventions to increase vaccination acceptance and uptake.
To support EU/EEA countries to take such action, ECDC has published the report 'Tools and methods for promoting vaccination acceptance and uptake: a social and behavioural science approach' [3]. The report compiles a set of operational tools in usable and adaptable formats that fit the real-life context that public health authorities work in and describe vaccination programmes that can help tailor their efforts to the specific needs and challenges of diverse communities.
In addition, the deployment of modern digitalised immunisation information systems to identify and reach people who are unvaccinated is critical and should form an integral part of national efforts to improve the performance and management of the overall national immunisation programme.
Continuous EU and national investment in high-quality surveillance and prompt outbreak investigations are key to closely monitoring the epidemiology of vaccine-preventable diseases in the EU/EEA and to identifying and addressing immunity gaps in the population.
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