our years ago, the World Health Organization (WHO) had to postpone its objective-to eliminate measles from the European region by 2015-to 2020. It had become obvious that it was not possible to reach this milestone in time (e1, e2). By comparison with Europe, the entire American continent had successfully achieved measles elimination in 2016, with a vaccination rate of >95% (1). In the WHO European Region, measles continues to be endemic in 11 of 53 countries (2). In Germany several measles outbreaks were documented in recent years, in spite of increasing childhood vaccination rates (e3). In 2015, almost 2500 measles cases were reported (incidence 3.1/100 000), which means that Germany had clearly missed WHO's elimination target (incidence <0.1/100 000 and interrupted transmission for >36 months) (Figure 1) (e3). In 2016, Germany, together with Austria and Switzerland, was able to interrupt endemic transmission for at least 12 months, which constitutes an important step towards measles elimination in Germany as well as in Europe (3). Whether this trend continues remains to be seen; particularly as measles case numbers in 2017 were more than three times those of 2016 (4). In this article we will discuss why Germany-like Romania, France, Italy, and Georgia, among others-continues to be among the number of European countries where measles is still not eliminated. This is particularly relevant on the background that measles vaccination in Germany continues to have insufficient coverage rates compared with other standard vaccinations (Figure 2). This article provides an overview over existing vaccination gaps in measles, barriers to vaccination in childhood and adulthood, and strategies to overcome these barriers. Methods We conducted a PubMed search for relevant publications. We used the following search terms: "measles", "vaccination", "hesitancy", "barrier", "antivaccination attitude", "compulsory", "Germany", "refusal", "strategy", "review". We included German language and English language publications. We complemented our search by searching the internet pages of the Robert Koch Institute (RKI), the WHO European Region group, and the WHO Strategic Advisory Group of Experts (SAGE) on Immunization. We used relevant abstracts to identify articles about vaccination fatigue and barriers that described intervention strategies. Furthermore, we included articles Summary Background: The World Health Organization (WHO) set the year 2020 as a target date for the eradication of measles in Europe, yet Germany is still far away from this goal. In this article, we provide an overview of current vaccination gaps and barriers to vaccination among children and adults in Germany, as well as potential strategies for overcoming them. Methods: This review is based on pertinent publications identified by a selective literature search in PubMed (Medline). Results: Measles vaccinations are not carried out in the appropriate timely fashion in Germany. Moreover, current vaccination rates among both children and adults are too low to achiev...