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The number of measles cases in Europe increased by 477% between 2009 and 2011. More than 37,000 people were infected last year, with eight children dying from complications of the disease. Most had not been vaccinated.

Now though, we could be seeing the earliest signs of a reprieve. At 1,447, the number of cases is still well above the levels seen five years ago but there were substantially fewer reported measles infections in January and February this year than there were in the first two months of 2011.

A new report from the European Centre of Disease Prevention and Control (ECDC) reveals two cases of measles-related encephalitis – an infection causing swelling of the brain – and no deaths in January and February.

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One in four people who contracted measles in Europe in recent years have been hospitalised, according to a new video report broadcast on Euronews.

The short film, supported by the European Centre for Disease Prevention and Control (ECDC), looks at some of the personal stories behind Europe’s shocking measles statistics.

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The World Health Organization’s (WHO) is set to support an ambitious new blueprint for getting vaccines to those who need them most.

Experts from across the world will gather later this month for the World Health Assembly – the WHO’s key decision-making body – to debate the Global Vaccine Action Plan which has been drawn up by the Decade of Vaccines Collaboration.

The latest draft of the Action Plan has been published as part of an exhaustive consultation exercise which saw 1,100 contributions submitted from more than 140 countries. Academics, policymakers, as well as representatives from the private sector and non-governmental organisations fed into the process which began last year.

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Immunising older people against influenza can cut hospital admissions and reduce the impact of certain chronic conditions like heart disease, lung disease and diabetes, according to a leading geriatrician.

Dr Janet McElhaney, Professor of Medicine and the Alan M. McGavin Chair in Geriatrics Research, Department of Medicine, University of British Columbia, Vancouver, Canada, says the link between chronic long-term illnesses and influenza has received insufficient attention.

Speaking at the Geneva Health Forum, Dr McElhaney noted that older people with certain non-communicable diseases (NCDs) are at higher risk of contracting influenza and are more likely to suffer severe illness following infection. 

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The prospect of prescribing vaccines based on individual genetic make-up and previous immune system ‘experience’ once seemed remote but researchers are beginning to think the unthinkable.

Just as some patients respond better to chemotherapy than others, the effect of a vaccine can vary in some individuals. With cancer treatments, genes are the major factor but for vaccines previous infection and vaccination history also play a role.

Could the ultimate destination be a simple blood test that helps doctors decide which vaccine – and which delivery method – is best suited to their patient?

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The number of measles cases in Europe has risen considerably in recent years. Experts say parents and health professionals have grown complacent and underestimate the risk of vaccine-preventable diseases, but the WHO believes measles can be eliminated in Europe if immunisation rates improve.

In this video discussion, Dr Dina Pfeifer of the World Health Organization Regional Office for Europe, and Dr Uwe Ehrentreich, a consultant paediatrician, address the factors behind Europe’s measles problem and discuss ways to improve vaccination uptake.

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Measles can be eliminated in Europe, a leading expert believes, but sustained effort by national governments and public health authorities is required.

Dr Marc Sprenger, director of the European Centre for Disease Prevention and Control (ECDC), said measles deserves special attention by policymakers and public health experts given the thousands of cases recorded in Europe in recent years.

Writing in a special edition of The Parliament magazine which features articles on immunisation from politicians, doctors, NGOs and development experts, he notes that up to 25% of measles cases results in hospitalisation.

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Vaccination is “safe, necessary and ethical”, according to the group representing European doctors which says parents should be encouraged to follow recommended immunisation programmes.

Dr Konstanty Radziwill, President of the Standing Committee of European Doctors (CPME), said doctors working in primary care – such as general practitioners and paediatricians – are confronted with questions about the safety of vaccines and must reassure parents that “vaccinating their children is much safer than not vaccinating them”.

“Doctors should convince doubting parents to vaccinate their children according to the current vaccination plan in the first place. In addition, they should also advise them to vaccinate their children with additional shots according to the child’s health condition,” Dr Radziwill told Vaccines Today.  

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Pharmacists should have an increased role in advising on, and administering, vaccines for flu and other vaccine-preventable illnesses, according to Pharmaceutical Group of the European Union (PGEU).

John Chave, Secretary General of the PGEU, said pharmacists across Europe view advising patients on vaccination as part of their core activity but some are now moving into delivering immunisation services.

A number of countries, including Portugal, Ireland and the UK, have given pharmacists a hands-on role in administering vaccines – something which is already routine in the US and Australia. Chave said pharmacy vaccination has been a huge success in the US in particular, resulting in higher levels of vaccine coverage.

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Parents who opt out of recommended immunisation programmes should understand the risks and responsibilities their decision brings, according to the World Health Organisation’s Europe office.

In a new guide for parents, published to mark European Immunization Week, WHO Europe says that by taking the decision to delay or refuse vaccines, parents could put their child’s health at risk.

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Before having their children vaccinated, parents are often keen to discuss vaccines with their doctor or nurse. But are busy health professionals equipped to deal with their concerns?

Research shows that parents look to other parents and to their doctor  when they have questions about vaccination. The vast majority then decide stick to the recommended vaccine schedule.

However, some parents deviate from the ideal immunisation programme, a fact that is of growing concern to medical experts.

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A number of factors are at play when we decide whether to get ourselves or family members vaccinated, including a strong sense of responsibility when taking decisions for others, according to Dr Nick Sevdalis, lecturer in patient safety at Imperial College London.

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Scare stories about vaccinations are not created by the media but can be exploited to sell newspapers or boost TV ratings, according to award-winning investigative journalist Brian Deer.

He said journalists should be careful about the integrity and expertise of the sources they use when reporting about alleged vaccine controversies.

Deer also believes that the era of “big media” shaping the public agenda is over now that new media channels have handed ultimate power to consumers.

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While prior immunisation against seasonal flu was an indicator of willingness to be vaccinated against H1N1 flu during the 2009 pandemic, the lower-than-expected uptake of the pandemic vaccine could weigh on seasonal flu vaccination rates in years to come.

Dr Michael Schwarzinger of INSERM in France has studied the role of doctors in France in the H1N1 flu pandemic and highlighted some of the reasons why vaccination rates were low amongst healthcare professionals. He has also looked at how this influenced decision-making in the wider community.

He said the experience of the pandemic has taught a number of lessons about how vaccination should be administered and the importance of bringing GPs on board.

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Getting vaccines to people who need them most in developing countries is extremely challenging, not least because vaccines must be transported and stored under controlled refrigerated temperature conditions, referred to as “the cold-chain”.

For example, running immunisation programmes in remote regions of Pakistan or Nigeria means transporting vaccines long distances, often in regions where road networks and electricity supply are weak or unreliable and weather conditions are often harsh.

The global push to eradicate polio is a classic example of how difficult it can be to get the vaccine under proper storage conditions to the people in rural villages. Now, the EU believes that the innovation that went into developing vaccines must be matched by innovative ways to ensure they can be moved around the world without compromising on safety or effectiveness. 

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At the recent TEDxChange event hosted by The Gates Foundation, Melinda Gates led a series of talks on the simple but ambitious theme of making the world a better place.

One of the most remarkable stories was of the so-called Revolutionary Optimists who empower local communities to effect real change.

In practice, this means mobilising children in Kolkata, India, to go door-to-door with home-made megaphones, mobile phone technology and GPS maps, encouraging neighbours to avail of polio vaccination programmes.

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The Internet and social media networks play a critical role in how information is shared, according to Philip Weiss, a communications consultant, who says institutions, industry and health officials need to learn how to use these tools in order to become credible players in public health stories.

Weiss, who founded ZN, an e-communication agency, said the 2009 H1N1 influenza pandemic showed how information can spread rapidly and from very unlikely sources. When there is no response negative messages can take hold, he said.

One of the barriers to embracing new technologies is the mindset of people in health authorities, industry and scientific institutions, Weiss said.

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The decision to vaccinate yourself or your family can be viewed as a social contract whereby the majority of individuals take an action in the interest of protecting the entire community.

According to Angus Thomson, Director of Vaccination Advocacy at Sanofi Pasteur, who was the special guest at a TEDxBrussels event on April 5, the success of polio and smallpox vaccination gave birth to a new unwritten contract to cooperate in the name of public health.

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Those concerned with boosting public engagement with scientific issues should be more open to innovative methods of communication, according to Claire Matterson, Director, Medical Humanities & Engagement at the Wellcome Trust.

She called for greater experimentation and said scientists keen on public engagement should be willing to go where the people are – even if that means setting up camp at music festivals.

Claire Matterson was speaking to Vaccines Today at a conference on immunisation policy hosted by Fondation Merieux.

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