Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Suboptimal MMR Vaccination Coverages – a Constant Challenge for Measles Elimination in Romania

Version 1 : Received: 12 December 2023 / Approved: 12 December 2023 / Online: 12 December 2023 (16:26:04 CET)

A peer-reviewed article of this Preprint also exists.

Stanescu, A.; Ruta, S.M.; Cernescu, C.; Pistol, A. Suboptimal MMR Vaccination Coverages—A Constant Challenge for Measles Elimination in Romania. Vaccines 2024, 12, 107. Stanescu, A.; Ruta, S.M.; Cernescu, C.; Pistol, A. Suboptimal MMR Vaccination Coverages—A Constant Challenge for Measles Elimination in Romania. Vaccines 2024, 12, 107.

Abstract

Measles is targeted for elimination since 2001, with significant reduction in cases recorded worldwide, but outbreaks occur periodically due to immunization gaps. The present study analyzes the evolution of vaccination coverage rates (VCR) in Romania, a EU country with large measles epidemics during the last two decades, including an ongoing outbreak in 2023. Vaccination against measles is included in the National Immunization Program from 1979, initially as a single dose, and since 1994, with 2 doses. The vaccine uptake was initially high, with national VCR of >97%. However, from 2010 onwards, the VCR dropped and remained constantly under 90%. This decline was caused by several factors, including a decreasing number of general practitioners, discontinuities in vaccine supply, emigration, with increased numbers of children lost to follow-up and a surge in vaccine hesitancy. Additional decreases in the already low levels of VCR were recorded during the COVID-19 pandemic: in 2022 the VCR reached the lowest level in the last decade, with 83.4% for the first dose (6.6% decrease compared to 2019) and 71.4% for the second dose (4.4% decrease compared to 2019), with important subregional differences. The constant suboptimal vaccination coverage rate in Romania threatens the progress toward measles elimination.

Keywords

measles; vaccine coverage; outbreak, Romania, vaccine hesitancy

Subject

Medicine and Pharmacology, Epidemiology and Infectious Diseases

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