Measles still spreads in Europe: who is responsible for the failure to vaccinate?

All countries in the European Region of the World Health Organization (WHO) have renewed their commitment to eliminate measles transmission by 2015. Measles elimination is a feasible target but requires vaccination coverage above 95% with two doses of a measles-mumps-rubella vaccine (MMR) in all population groups and in all geographical areas. Measles has re-emerged in the EU recently, due to suboptimal immunization levels that led to accumulation of susceptible populations over the last years. In fact, while an overall decreasing trend had been observed until 2009, the number of cases increased by a factor of four between 2010 and 2011. According to vaccination coverage data reported to the WHO, between 2000 and 2010, almost 5 million individuals in the EU in the age group 2-12 had not had MMR vaccination. Catch-up vaccination activities for susceptible populations are paramount in order to reach the elimination goal, but only feasible if a multi-component approach is put in place quickly and efficiently. Advocacy and communication are key strategic areas.