Six Countries within WHO European Region Lose Measles Elimination Status

Across the WHO European Region, 33,998 measles cases were reported in 2025, including 23,436 confirmed cases. This represents a 73.3 percent decrease compared to the 127,412 cases reported in 2024. While the decline in cases in 2025 likely reflects intensified outbreak response and the reduction of susceptible individuals in previously under-vaccinated communities, the underlying drivers of resurgence remain largely unaddressed.  

Based on 2024 country data, the European Regional Verification Commission for Measles and Rubella Elimination concluded that the number of countries with ongoing or re-established endemic transmission rose from 12 to 19, the most significant setback to regional elimination efforts in recent years. Measles is currently considered endemic in 13 countries, including France, Germany, and Italy. Regaining elimination status requires interruption of endemic transmission for at least 12 consecutive months, with formal WHO verification only after three years of sustained interruption.  

Measles transmission dynamics in the European Region have shifted from sporadic import-related outbreaks to sustained community spread. Recent outbreaks disproportionately affect young children and unvaccinated individuals. The increase in cases comes after low levels of measles activity during 2020-2022. COVID-19 mitigation measures disrupted routine vaccinations and delayed catch-up campaigns. With the resumption of travel and social interaction, accumulated susceptibility enabled renewed transmission.  

Multiple factors are contributing to the resurgence of measles, but the primary driver remains immunity gaps resulting from suboptimal vaccination coverage. Preventing measles transmission requires at least 95 percent two-dose coverage with a measles-containing vaccine at all subnational levels. However, the WHO and UNICEF estimates for 2024 indicate that only ten countries in the European Region (Andorra, Armenia, Belarus, Cyprus, Hungary, Iceland, Portugal, Tajikistan, Turkmenistan, and Uzbekistan) reached or exceeded this threshold for both doses.

Even in these countries, strong national averages can conceal subnational pockets of under-vaccinated populations. Localized immunity gaps are sufficient to sustain outbreaks and undermine elimination status. Second-dose uptake remains particularly weak in several settings, and catch-up efforts have been delayed or under-resourced. Declining vaccine confidence and the spread of misinformation further complicate control efforts. International travel further increases the likelihood that imported cases will ignite outbreaks in areas with persistent immunity gaps.  

Although case numbers declined in 2025, the risk of measles outbreaks remains. Maintaining at least 95 percent two-dose coverage in every community is essential to prevent outbreaks and achieve herd immunity. If vaccine coverage gaps persist, further outbreaks and additional losses of elimination status remain likely. High coverage not only protects vaccinated individuals but also safeguards those who cannot be vaccinated, including infants who are too young to be vaccinated and people who cannot receive the vaccine for medical reasons, such as those who are immunocompromised. All travelers should ensure they are up to date on their childhood immunizations, including measles, prior to travel. This represents the most complete data available as of Feb. 16.

Learn more about leveraging our industry-leading regional and medical experts for intelligence that helps your organization stay ahead of health risks to your people and operations.