Evolving measles status and immunization policy development in six European countries

Abstract

Developing and implementing new immunization policies in response to shifting epidemiology is a critical public health component. We adopted a mixed-methods approach (via narrative literature review [101 articles] and 9 semi-structured interviews) to evaluate policy development in response to shifting measles epidemiology in six European countries (Italy, Belgium, Germany, Romania, UK, and Ukraine); where policies and strategies have evolved in response to country-specific disease and vaccination patterns. Periodic outbreaks have occurred in all countries against a background of declining measles-containing-vaccine (MCV) uptake and increasing public vaccine hesitancy (with substantial regional or social differences in measles burden and vaccine uptake). Health-care worker (HCW) vaccine skepticism is also seen. While many outbreaks arise or involve specific susceptible populations (e.g., minority/migrant communities), the broader pattern is spread to the wider (and generally older) population; often among incompletely/non-vaccinated individuals as a legacy of previous low uptake. Immunization policy and strategic responses are influenced by political and social factors, where public mistrust contributes to vaccine hesitancy. A strong centralized immunization framework (allied with effective regional implementation and coherent political commitment) can effectively increase uptake. Mandatory vaccination has increased childhood MCV uptake in Italy, and similar benefits could be anticipated for other countries considering vaccine mandates. Although possible elsewhere, socio-political considerations render mandating impractical in other countries, where targeted immunization activities to bolster routine uptake are more important. Addressing HCW skepticism, knowledge gaps, improving access and increasing public/community engagement and education to address vaccine hesitancy/mistrust (especially in communities with specific unmet needs) is critical.

Systematic review of health and disease in Ukrainian children highlights poor child health and challenges for those treating refugees

“…After duplicates were removed, the titles and abstracts of 1,628 reports were reviewed by one of the authors (JFL), and 131 met the eligibility criteria (Figure 1). The current review was primarily based on 107 full papers, 2‐108 but, due to the scarcity of data, we also chose to cite five relevant abstracts 109‐113 for a more complete picture of child health in Ukraine. Our literature search was limited to papers published in English.…”

2/m mit Fieber, Schnupfen, Husten, Hautausschlag

“…hätte vorbeugen können. Der gelegentlich, auch von irregeleitetem medizinischen Fachpersonal, vertretenen Auffassung, dass Masern eine leichte Erkrankung und das Überstehen der Erkrankung für die Entwicklung des Kindes förderlich seien, gilt es entgegenzutreten [ 5 ]. Falls die Eltern der stationären Aufnahme zustimmen, ist später Zeit, über die ausstehenden Impfungen zu diskutieren und ggf.…”

You must be myths-taken: Examining belief in falsehoods during the COVID-19 health crisis

“…Over 20 years ago, Wakefield [ 9 ] published a later retracted and disproven paper claiming that childhood vaccinations lead to autism. This claim has driven parental hesitancy regarding child vaccinations and contributed to a resurgence in preventable childhood diseases [ 10 ]. A systematic review by Borges Do Nascimento and colleagues [ 11 ] found that misinformation can create more disharmony among people, lead to delays in obtaining healthcare, and contribute to misinterpretations of evidence.…”