Abstract
Introduction: Despite the widespread availability of vaccines, the incidence of vaccine-preventable childhood diseases (VPCD) started to grow in recent years. The aim of the study was to compare the annual incidence of selected VPCDs in the EU (European Union) and EFTA (European Free Trade Association) countries in the period of the last 5 years (2014–2019 or other intervals, depending on data availability), and the country-specific vaccine schedules. Methods: VPCD incidence rates in Europe were based on “The Surveillance Atlas of Infectious Diseases” by the ECDC (European Centre for Disease Prevention and Control); vaccination schedules were based on ECDC reports. Results: The obligation to vaccinate was not universal, and it generally only applied to two preparations: the MMR (measles, mumps, rubella) vaccine and the one against polio. During the study, the situation associated with mumps did not change or improve in individual countries; the median incidence amounted to 30 cases. The median incidence associated with rubella amounted to 1 case, but in a few countries, it grew very rapidly, i.e., in Germany, Italy, and Romania; in Poland, the incidence was clearly decreasing, from 5923 to 1532 cases. The most dynamic situation concerned measles. The total median was 2.4 cases per 100,000 population; the only one country with falling incidence was Germany. The diseases associated with Streptococcus pneumoniae and Neisseria meningitidis remained at a stable level in all analyzed countries. Conclusion: Vaccine schedules differ among the countries, so does the epidemiological situation of selected diseases. Morbidity on measles was the most disturbing phenomenon: the incidence rate increased in almost 40% of all countries, regardless of the obligation to vaccinate. The increasing incidence of VPCD may be due to anti-vaccine movements, the activity of which is often caused by mistrust and spreading misinformation. In order to better prevent the increase in morbidity, standardization of vaccine schedules and documentation should be considered in the EU countries.
Highlights
Despite the widespread availability of vaccines, the incidence of vaccinepreventable childhood diseases (VPCD) started to grow in recent years
We found no simple correlation between mandatory vs. non-mandatory policy and the observed incidence of measles, mumps, rubella, S. pneumoniae, and N. meningitides infections in studied countries
The situation has no relation to the historical context, i.e., high incidence occurs in both countries of the former Eastern Bloc, among others, Lithuania, Poland, and Romania, as well as in the so-called Old Union, Spain, France, or Italy
Summary
Despite the widespread availability of vaccines, the incidence of vaccinepreventable childhood diseases (VPCD) started to grow in recent years. Morbidity on measles was the most disturbing phenomenon: the incidence rate increased in almost 40% of all countries, regardless of the obligation to vaccinate. The introduction of vaccines against measles, rubella, mumps, polio, chicken pox, rotavirus diarrhea, as well as meningococcal and pneumococcal infections (vaccine-preventable childhood diseases, VPCD), bore the greatest importance in reducing infant and child mortality [1]. Despite the availability of vaccines against childhood diseases, those diseases are still quite common, and, in recent years, more and more cases were being reported despite the fact that most of them are under strict epidemiological surveillance [2].
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