Evolving measles status and immunization policy development in six European countries

Area of Science:

• Public Health
• Epidemiology
• Health Policy

Background:

• Shifting measles epidemiology and declining vaccine uptake pose public health challenges.
• Increasing vaccine hesitancy and health-care worker skepticism complicate immunization efforts.
• Measles outbreaks spread widely, affecting incompletely or non-vaccinated individuals.

Purpose of the Study:

• To evaluate immunization policy development in response to changing measles epidemiology in six European countries.
• To understand the influence of political and social factors on immunization strategies.
• To identify effective approaches for increasing measles-containing-vaccine (MCV) uptake.

Main Methods:

• A mixed-methods approach was employed, including a narrative literature review of 101 articles.
• Semi-structured interviews with 9 participants were conducted.
• Policy and vaccination patterns were analyzed across Italy, Belgium, Germany, Romania, UK, and Ukraine.

Main Results:

• Policies and strategies evolved based on country-specific disease and vaccination patterns.
• Public mistrust and vaccine hesitancy significantly influence immunization policy responses.
• Mandatory vaccination in Italy successfully increased childhood MCV uptake.

Conclusions:

• A strong, centralized immunization framework with political commitment enhances vaccine uptake.
• Mandatory vaccination may be effective but faces socio-political barriers in some countries.
• Targeted immunization, addressing health-care worker skepticism, and community engagement are critical for improving vaccine uptake and combating hesitancy.