Marco Montalti1, Anna Kawalec2, Erica Leoni1, Laura Dallolio1. 1. Department of Biomedical and Neuromotor Sciences, Unit of Hygiene, Public Health and Medical Statistics, University of Bologna, via San Giacomo 12, Bologna 40126, Italy. 2. Department of Hygiene, Wroclaw Medical University, Mikulicza-Radeckiego 7, Wroclaw 50-345, Poland.
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.
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.
Entities:
Keywords:
European countries; mandatory vaccination; measles; recommended vaccination; vaccination coverage
Authors: Lorena Charrier; Jacopo Garlasco; Robin Thomas; Paolo Gardois; Marco Bo; Carla Maria Zotti Journal: Int J Environ Res Public Health Date: 2022-09-03 Impact factor: 4.614