ECDC: Highly preventable measles infections see almost tenfold increase in Europe

Stockholm, 14 March 2025

The European Centre for Disease Prevention and Control (ECDC) warns that a decline in vaccination uptake has led to an almost ten-fold increase in the number of measles cases in the EU/EEA and around the world.

The warning comes after 32 265 people in the European Union and European Economic Area (EU/EEA) were diagnosed with measles in 2024, a significant rise from 3 973 the previous year. Europe continues to experience recurring outbreaks of measles despite a highly safe, effective and accessible vaccine included in all EU/EEA national immunisation programmes.

The steep rise in infections identified by ECDC is driven by consistently suboptimal vaccination uptake. Children below 1 year of age, who are too young to be vaccinated are paying the highest price as an accumulation of unprotected population groups continue to contribute to the spread of measles. Almost 90% of people who were diagnosed with measles in 2024 had not been vaccinated. It is essential that at least 95% of the eligible population is fully vaccinated.

“Vaccination is an act of solidarity. When we protect ourselves we also protect others. We must be able to prevent the preventable. It is essential that we redouble our efforts to move forward, save lives and make measles a disease of the past. This requires concerted European action on timely vaccination and closing immunity gaps,” says Pamela Rendi-Wagner, Director of ECDC.

Measles activity tends to peak in winter and spring. With Easter holidays approaching, prompting increased international travel, urgent action is needed to prevent a similar number of infections in 2025.

ECDC urges that parents and people who may not have been vaccinated check their own as well as their children’s vaccination status and get catch-up doses if necessary, whether staying at home or travelling.

ECDC is working closely with EU/EEA Member States to develop resources and strategies informed by social and behavioural sciences to increase vaccination acceptance and uptake. In addition, through its prevention community of practice – ECDC Lighthouse – the Centre is facilitating best practice and experience sharing to enable robust prevention activities at Member State level. Targeted country support is also made available to Member States as needed.

Recent data published by the World Health Organization indicates that the increase in measles cases in the EU/EEA reflects a larger trend. The WHO European Region recorded 127 350 measles diagnoses in 2024 – more than double the previous year.

Measles is a highly contagious disease that can spread between people very easily. It can have life altering consequences including blindness, deafness and severe immune system damage.

ECDC will participate European Immunization Week 2025 in the last week of April to promote the benefits of vaccination and ensure people of all ages are protected against infectious diseases.

Further information

• For more information, click here.
• The data is available in the Monthly measles and rubella monitoring report.

ECDC Background: Measles on the rise again in Europe: time to check your vaccination status

Stockholm, 11 March 2025

Data on measles cases in the European Union and European Economic Area (EU/EEA) for the last twelve months show a considerable rise in notifications compared to 2023. This indicates that the virus is circulating in the region and the number of cases will probably increase during the spring of 2025. Immunisation with two doses of the Measles, Mumps and Rubella (MMR) vaccine is the safest and most effective way to protect against this highly contagious disease. However, eight out of ten people who were diagnosed with measles in the EU/EEA in the last year were not vaccinated. Adults and parents are encouraged to check their vaccination history and, if in doubt, consult a healthcare professional.

Data presented in the monthly measles and rubella update by the European Centre for Disease Prevention and Control (ECDC) indicate ongoing transmission of measles across a number of countries in EU/EEA, with a steep rise in cases reported during 2024. After a period of unusually low measles activity during the COVID-19 pandemic, an uptick was initially noted in 2023, with 3 973 reported cases in the EU/EEA. 

Between 1 February 2024 and 31 January 2025, a total of 32 265 people were diagnosed with measles. During this period, Romania (27 568), Italy (1 097), Germany (637), Belgium (551) and Austria (542) reported the highest number of cases across the EU/EEA. During the period, Romania recorded 18 deaths attributed to measles and Ireland also recorded one death.

The ongoing transmission indicates gaps in vaccination coverage against this preventable illness — among children, adolescents and adults alike. 

Measles is a highly contagious disease. It transmits easily from person to person through the air (for example, when an infected person coughs or sneezes) and spreads rapidly in communities among people who have not been vaccinated or are not fully immunised.

In 2024, the peak in measles cases reported across the EU/EEA was observed in the first six months of the year. In line with the seasonal pattern of the disease, a further increase in the number of cases is expected during the spring of 2025. 

Sub-optimal measles vaccination coverage across the EU/EEA

Prevention of measles outbreaks and protection of vulnerable populations requires that at least 95% of the population eligible for vaccination receive two doses of the MMR vaccine. However, vaccination levels in the EU/EEA still fall short of this target, with estimates from 2023 showing that only four countries (Hungary, Malta, Portugal and Slovakia) report such coverage for both doses. 

This leaves many communities vulnerable to measles, including children who are too young to be vaccinated or those who cannot be immunised for medical reasons and therefore rely on a high vaccination coverage in the overall population.

Measles vaccination coverage remains suboptimal in many EU/EEA countries. Sustained improvements are required in the coverage of routine childhood immunisation programmes, as well as closing immunity gaps in adolescents and adults who have missed vaccination opportunities in the past.

Based on the available data, young children between one and four years of age and adults aged thirty years and older had their distinctive share among the group of unvaccinated people who contracted measles last year. 

Among those diagnosed with measles between the beginning of 2024 and early 2025 with information available on their vaccination status, 25 503 (86%) were unvaccinated — this means that eight out of ten people who fell ill with measles during that period had not been immunised. The same applies to children aged one to four years (even though this age group is the focus of national immunisation programmes): 84% of those children with information available on their vaccination status had not been vaccinated when they contracted measles. 

No time for measles: check your vaccination status

A safe and effective vaccine has been used for decades to prevent measles. All EU/EEA countries include the recommended two doses of MMR vaccine in their national immunisation schedule. The first dose is usually given between 12−15 months of age and the second dose between three and seven years of age, with some variation among countries. Two doses of the MMR vaccine are needed to achieve full protection against measles.

An infectious disease such as measles will only be unlikely to spread from person to person if a sufficiently large proportion of the population achieve immunity. This also provides protection for vulnerable groups (so-called herd immunity), such as infants under one year, who are more exposed to measles and its complications because they are too young to be vaccinated. 

In outbreak situations, or before travelling to a country where measles is endemic, healthcare professionals might suggest an early dose of the MMR vaccine (i.e. before the child turns one year) in line with national recommendations. However, these children will still need to adhere to the national vaccination schedule (i.e. in addition to the early dose, they should receive the two doses of MMR vaccine at the recommended ages to achieve full immunity). 

Measles can also affect adults if they are not immunised – by being fully vaccinated or because they have already had measles. It is therefore equally important for adults to check their immunisation status in order to prevent illness and further transmission. 

Given that measles transmission and outbreaks are being reported across the globe by WHO, travellers are encouraged to check their vaccination status before travelling abroad as the MMR vaccine takes at least two weeks to become effective. 

Recommendations for adults and parents/caregivers

• Check vaccination status: ensure that you and your children are up-to-date with the MMR vaccination schedule, whether you are staying at home or plan to travel.
• If unsure about your own vaccination history or if you need guidance on vaccinating children, consult a healthcare professional.
• Be mindful of typical measles symptoms (both as a healthcare professional and a potential patient):
  • high fever
  • cough
  • runny nose
  • red, watery eyes
  • a characteristic red rash that usually starts at the hairline and spreads down to the rest of the body

Measles infection can lead to severe complications including pneumonia, encephalitis, and even death.

Source – ECDC