Childhood vaccinations

All EU countries have established childhood vaccination programmes to reduce the spread of many infectious diseases and related deaths, although the number and type of compulsory or recommended vaccines vary to some extent across countries.

In recent years, some parts of Europe witnessed a steep resurgence of vaccine-preventable diseases due to declining vaccine coverage driven at least partly by anti-vaccine campaigns. To counter these alarming trends, over the past years the European Commission has repeatedly called for stronger efforts and cooperation to tackle vaccine hesitancy and improve vaccination coverage to reduce the spread of vaccine-preventable diseases (European Commission, 2018). This has become even more important following the COVID-19 pandemic to avoid any additional burden on health systems.

The confinement measures following the COVID-19 outbreak have resulted in a sharp reduction in the spread of communicable diseases like measles between March and August 2020, but these reductions may only be temporary if vaccination coverage does not go up. One of the indirect consequences of the COVID-19 pandemic is that it disrupted the implementation of routine vaccination programmes in some countries, as some people feared exposure to the new virus, and restrictions on the movement of people impacted children’s accessibility to immunisation services (WHO, 2020).

Vaccination against measles is included in all national childhood vaccination programmes in Europe, whereas vaccination against hepatitis B has been included in a growing number of countries, but not yet in most Nordic countries and Hungary (ECDC, 2020a). WHO has recommended a coverage of at least 95% of children with two doses of measles-containing vaccine and three doses of the hepatitis B vaccine by 2020 (WHO, 2012; WHO, 2017).

In 2018, on average across EU countries, 94% of one-year-old children received at least one dose of measles vaccination. Half of EU countries had not reached yet the target of at least 95% coverage (Figure 6.3). Measles outbreaks have occurred in recent years in several countries, even in those that had previously eliminated or interrupted endemic transmission. In 2019, WHO announced that Albania, the Czech Republic, Greece and the United Kingdom had lost their measles elimination status due to continuous transmission in 2017 and 2018. During the 12-month period from March 2019 to February 2020, the highest number of measles cases were reported in France (2 466), Romania (1 542), Italy (1 353), Bulgaria (1 347) and Poland (1 032). Most measles cases were reported among people who were not vaccinated, including children below age one who were too young to have received the first dose of the vaccine but also adolescents and adults (ECDC, 2020b).

On average, 93% of one-year-old children received hepatitis B vaccination in 2018 across those EU countries where this vaccination was part of the national immunisation programme. The vaccination rate was above the 95% target in several countries such as Malta, Portugal, Belgium, Cyprus, the Slovak Republic, Greece, Latvia, Luxemburg and Italy. However, less than 90% of one-year-old children were covered in Austria, Bulgaria, Germany, Montenegro and Switzerland (Figure 6.4). Data on childhood vaccination rate for hepatitis B are not available in most Nordic countries except Sweden, because this vaccine is not yet part of the general infant vaccination programme, although it is provided to high-risk groups.


ECDC (2020a), Monitoring the Responses to Hepatitis B and C Epidemics in the EU/EEA Member States, 2019, Stockholm.

ECDC (2020b), Monthly measles and rubella, Stockholm.

ECDC (2020c), Communicable Disease Threat Report, Week 28, 5-11 July 2020, Stockholm.

European Commission (2018), Proposal for a Council Recommendation on Strengthening Cooperation against Vaccine Preventable Diseases, European Commission, Brussels.

WHO (2020), Special feature: immunisation and COVID-19, Geneva.

WHO (2017), Global Hepatitis Report, Geneva.

WHO (2012), Global Measles and Rubella Strategic Plan: 2012-20, Geneva.

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