© Jim Goodson

Data presented in the monthly measles and rubella update by the European Centre for Disease Prevention and Control (ECDC) indicate ongoing transmission of measles across a number of countries in EU/EEA, with a steep rise in cases reported during 2024. After a period of unusually low measles activity during the COVID-19 pandemic, an uptick was initially noted in 2023, with 3 973 reported cases in the EU/EEA.

Between 1 February 2024 and 31 January 2025, a total of 32 265 people were diagnosed with measles. During this period, Romania (27 568), Italy (1 097), Germany (637), Belgium (551) and Austria (542) reported the highest number of cases across the EU/EEA. During the period, Romania recorded 18 deaths attributed to measles and Ireland also recorded one death.

The ongoing transmission indicates gaps in vaccination coverage against this preventable illness — among children, adolescents and adults alike.

Measles is a highly contagious disease. It transmits easily from person to person through the air (for example, when an infected person coughs or sneezes) and spreads rapidly in communities among people who have not been vaccinated or are not fully immunised.

In 2024, the peak in measles cases reported across the EU/EEA was observed in the first six months of the year. In line with the seasonal pattern of the disease, a further increase in the number of cases is expected during the spring of 2025.

| Sub-optimal measles vaccination coverage across the EU/EEA 

Prevention of measles outbreaks and protection of vulnerable populations requires that at least 95% of the population eligible for vaccination receive two doses of the MMR vaccine. However, vaccination levels in the EU/EEA still fall short of this target, with estimates from 2023 showing that only four countries (Hungary, Malta, Portugal and Slovakia) report such coverage for both doses.

This leaves many communities vulnerable to measles, including children who are too young to be vaccinated or those who cannot be immunised for medical reasons and therefore rely on a high vaccination coverage in the overall population.

Based on the available data, young children between one and four years of age and adults aged thirty years and older had their distinctive share among the group of unvaccinated people who contracted measles last year.

Among those diagnosed with measles between the beginning of 2024 and early 2025 with information available on their vaccination status, 25 503 (86%) were unvaccinated — this means that eight out of ten people who fell ill with measles during that period had not been immunised. The same applies to children aged one to four years (even though this age group is the focus of national immunisation programmes): 84% of those children with information available on their vaccination status had not been vaccinated when they contracted measles.

| No time for measles: check your vaccination status  

A safe and effective vaccine has been used for decades to prevent measles. All EU/EEA countries include the recommended two doses of MMR vaccine in their national immunisation schedule. The first dose is usually given between 12−15 months of age and the second dose between three and seven years of age, with some variation among countries. Two doses of the MMR vaccine are needed to achieve full protection against measles.

An infectious disease such as measles will only be unlikely to spread from person to person if a sufficiently large proportion of the population achieve immunity. This also provides protection for vulnerable groups (so-called herd immunity), such as infants under one year, who are more exposed to measles and its complications because they are too young to be vaccinated.

In outbreak situations, or before travelling to a country where measles is endemic, healthcare professionals might suggest an early dose of the MMR vaccine (i.e. before the child turns one year) in line with national recommendations. However, these children will still need to adhere to the national vaccination schedule (i.e. in addition to the early dose, they should receive the two doses of MMR vaccine at the recommended ages to achieve full immunity).

Measles can also affect adults if they are not immunised – by being fully vaccinated or because they have already had measles. It is therefore equally important for adults to check their immunisation status in order to prevent illness and further transmission.