Countries in Europe and Central Asia reported 33,998 cases of measles in 2025, a decline of nearly 75% compared to 127,412 cases in 2024. This spectacular drop, however, masks a troubling reality: 19 countries now show continuous or re-established endemic transmission, compared to 12 the previous year. Six European countries, including Spain and the United Kingdom, have officially lost their measles elimination status. This situation represents the most significant setback in measles elimination in the region in years.
This contradiction illustrates a European health paradox: the capacity for rapid mobilization in the face of epidemics coexists with structural flaws that undermine decades of vaccination gains. More than 200,000 people in the region fell ill with measles over the past three years.
A decline that masks structural failure
The general downward trend in cases reflects both epidemic response measures and the gradual decline in the number of people susceptible to measles infection, as the virus has made its way through under-vaccinated communities. Many cases could have been prevented through higher routine vaccination coverage at the community level and faster outbreak response.
The figures reveal a troubling reality: the number of cases in 2025 still exceeds what was reported for most years since 2000, and some countries reported more cases in 2025 than in 2024. Romania remains the most affected country with 30,692 cases in 2024, followed by Kazakhstan with 28,147 cases.
In Spain, the situation is worsening: nearly 400 confirmed cases of measles were reported in 2025, a figure higher than in 2024, when approximately 200 cases had been reported according to available sources. The country perfectly illustrates this European contradiction where the overall decline coexists with alarming local resurgences.
Six countries lose their elimination status
Armenia, Austria, Azerbaijan, Spain, the United Kingdom, and Uzbekistan have re-established endemic measles transmission based on the number of cases in 2024, the World Health Organization (WHO) announced. This administrative decision, made in September 2025 but made public only in January 2026, reflects a troubling epidemiological reality.
The WHO defines measles elimination as the absence of endemic measles transmission in a defined geographic area for 12 months or more in the presence of effective surveillance. To regain elimination status, countries must interrupt endemic transmission and demonstrate that the virus is no longer circulating locally. The WHO only verifies measles elimination after three years without continuous local transmission.
The United Kingdom illustrates this instability. The country had been officially declared measles-free in 2016, lost that status when transmission re-established in 2018, then regained elimination status in 2021, after again interrupting measles spread. Measles vaccination rates among British children have fallen to 84.4%—well below the 95% level recommended by the WHO.
The collapse of herd immunity
The data reveal the scale of the challenge. Unless every community achieves 95% vaccination coverage, closes immunity gaps across all age groups, strengthens disease surveillance, and ensures rapid response to outbreaks, this highly contagious virus will continue to spread.
Measles is currently considered endemic in 13 countries, including France, Germany, and Italy. Only ten countries in the European region (Andorra, Armenia, Belarus, Cyprus, Hungary, Iceland, Portugal, Tajikistan, Turkmenistan, and Uzbekistan) have achieved or exceeded this threshold for two doses. Even in these countries, strong national averages can mask sub-national pockets of under-vaccinated populations.
Fewer than 80% of eligible children in Bosnia and Herzegovina, Montenegro, North Macedonia, and Romania were vaccinated with the first dose in 2023—well below the 95% coverage rate required to maintain herd immunity. In Bosnia and Herzegovina and Montenegro, coverage rates have remained below 70% and 50% respectively for five years or more.
Disinformation as an epidemic accelerator
In the current environment of rampant false information, it is crucial that people rely on verified health information from reliable sources such as the WHO, UNICEF, and national health agencies. Until vaccine hesitation fueled by the spread of misinformation is addressed, children will remain at risk of death or serious illness from measles and other vaccine-preventable diseases.
The consequences of vaccine misinformation are not hypothetical—they are real and tragic. There have been several recent cases of healthy children who died after contracting the highly contagious measles virus, or from measles complications that can emerge years after recovery from a measles infection.
Globally, the spread of misinformation about vaccine safety has contributed to the largest sustained decline in childhood vaccinations in 30 years, which UNICEF Director-General Catherine Russell characterized in 2022 as a “red alert” for child health.
The scale of this misinformation is evident in the statistics: according to the ECDC, among people whose vaccination status is known, 86% of those diagnosed with measles between early 2024 and 2025 were unvaccinated.
Coordinated response facing systemic limits
UNICEF and the WHO are working together with governments and with the support of partners, including Gavi, the Vaccine Alliance, and the European Union, to prevent and respond to measles outbreaks—by engaging with communities, training health workers, strengthening vaccination programs and disease surveillance systems, and launching catch-up measles vaccination campaigns.
Some countries demonstrate that recovery remains possible. Albania, Bulgaria, Lithuania, and Slovakia have interrupted measles transmission for at least 36 months. These successes demonstrate that even in a fragmented European environment, coordination can produce lasting results.
Yet fragility remains. It has been observed that late detection of measles outbreaks, slow and weak implementation of outbreak response measures, and absence or refusal of outbreak vaccination response among susceptible individuals result in prolonged transmission.
A vulnerability that reveals European flaws
Measles acts as a revealer of structural European weaknesses. The 2024 measles epidemics demonstrated that even with solid health systems in high-income economies and rapid case detection, measles outbreaks can occur, and the measles virus can re-establish itself as endemic. This is possible in any country if they do not know and address their risks regarding immunity gaps, response capacity, and vaccine acceptance among medical personnel and the public.
This vulnerability transcends national borders. As the European Union highlighted in its efforts toward digital regulation, Europe still struggles to translate its integration ambitions into concrete health results on the ground. The European recovery plan had revealed the limits of European fund absorption; measles now reveals the limits of European health coordination.
This situation represents the most significant setback in measles elimination in the region in years. The 75% drop in cases in 2025 testifies to Europe’s capacity to mobilize resources in the face of emergency. But the number of cases in 2025 still exceeds what was reported for most years since 2000. This contradiction reveals that Europe masters crisis management but struggles to build lasting herd immunity. Between tactical efficiency and strategic failure, measles exposes the true limits of European health integration.
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