Health care workers’ engagement critical for measles and rubella elimination

WHO immunization experts, speaking at the 31st Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID) held in Milan, Italy, 28 May–1 June 2013, outlined strategies to eliminate measles and rubella outbreaks in Europe and called on health care workers to play a greater role in closing immunity gaps.

Measles and rubella elimination in Europe: greater efforts needed

The WHO experts reported that substantial progress has been made towards eliminating measles and rubella in the European Region; however, outbreaks continue to occur:

  • 25 022 measles cases and 29 333 rubella cases were reported in the Region in 2012, mostly among unvaccinated persons.
  • For the first three months of 2013, 6147 measles cases have been reported, of which 2772 were recorded in Turkey alone.
  • Of the 4567 rubella cases reported for January–March 2013, almost all were reported by Poland.

Greater efforts are required to address the current challenges, particularly in high incidence countries. Apart from achieving and maintaining vaccination coverage of at least 95% across all sections of the population, high-quality surveillance of these diseases is also necessary. In addition:

  • Politicians, public health authorities and health care workers need to maintain stronger commitment to the elimination of these diseases.
  • The public needs to be empowered to demand vaccination. This can be achieved, for example, through dialogue between patients and health care providers that is both informative and responsive to patients’ concerns and fears.
  • Immunity gaps in the population need to be closed by targeting all those who are still susceptible and by using tailored immunization programmes to reach out to specific populations.

Increasing demand for vaccination

Although measles outbreaks over recent years have brought to light the vulnerability of certain populations such as ethnic minority groups, the focus should also be on underserved individuals in the general population in order to reach the elimination goal.

Multiple reasons have been identified for not being vaccinated or for not vaccinating one’s children. These can be broadly classified as involving:

  • complacency regarding vaccination;
  • confidence in the vaccine or the health service providing it; or
  • convenience of vaccination.

One approach to improve the public’s demand for vaccines, apart from the use of social media networking and diligent and responsible media communications, is to tailor immunization programme activities according to these individuals’ needs.


The European Society for Paediatric Infectious Diseases (ESPID) forms the basis for European investigators interested in infectious diseases in children and infection prevention in childhood. The society is engaged in a number of activities, including the organization of multicentre trials, international exchange of infectious disease fellows and an annual meeting.

This year’s annual meeting was chaired by Professor Susanna Esposito, Chairperson of ESPID’s International Scientific Committee and of ESPID’s local organizing committee, and Professor Pierre Van Damme, chairperson of the European Technical Advisory Group of Experts (ETAGE). Professor Esposito is also chairperson of Europe’s Regional Verification Committee for Measles and Rubella elimination.

Infographic: Measles cases in the WHO European Region 2007-2012